Individual provider Active NPI

Tish Tena, COTA

  • Occupational Therapy Assistant
  • Albuquerque, NM
National Provider Identifier
1902945769
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
1914 Issued in NM
Practice address
4216 Balloon Park Rd NE
Albuquerque, NM 87109-5801
Phone
(505) 344-5470
Fax
(505) 344-9343
NPI assigned
Feb 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 1914 NM Primary

Addresses

Primary practice location

4216 Balloon Park Rd NE
Albuquerque, NM 87109-5801

Mailing address

7639 Calle Comodo NE
Albuquerque, NM 87113-2365
Phone (505) 203-2495

Other identifiers 1

IdentifierTypeStateIssuer
1914OtherNMOCCUPATIONAL THERAPY ASST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1914NMMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cooperative Educational Services Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902945769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7639 CALLE COMODO NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871132365",
            "telephone_number": "505-203-2495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4216 BALLOON PARK RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871095801",
            "telephone_number": "505-344-5470",
            "fax_number": "505-344-9343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENA",
        "first_name": "TISH",
        "name_prefix": "Ms.",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NM",
            "license": "1914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL THERAPY ASST",
            "identifier": "1914",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.