Individual provider Active NPI

Lodia A Runco, O.T.

  • Occupational Therapist
  • Southfield, MI
National Provider Identifier
1912114232
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201001703 Issued in MI
Practice address
29829 Telegraph Rd
Suite 201
Southfield, MI 48034-1330
Phone
(248) 352-4263
Fax
(248) 352-2915
NPI assigned
May 17, 2007
Sex
Female
Sole proprietor
Yes

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 Therapist 225X00000X 5201001703 MI Primary

Addresses

Primary practice location

29829 Telegraph Rd
Suite 201
Southfield, MI 48034-1330

Mailing address

PO Box 523
Jenison, MI 49429-0523
Phone (616) 457-4919

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040506000139 MI Practitioner - Occupational Therapist in Private Practice 1658369673 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avery Arora MD PCGroup PAC ID 7315295524, 5 clinicians

Practice addresses (Care Compare)

7001 Orchard Lake Rd
Suite 220
West Bloomfield, MI 48322-3606
Phone (888) 392-4263

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Avery Arora, MD PC CurrentSince Aug 1, 2020 Accepting new patients
Kidney Specialists of Michigan PastSince Jan 1, 2024 Accepting new patients
North Alabama Medical Association LLC Past Accepting new patients
Klaus P. Kutschke, M.D., P.C. Past Accepting new patients

Organizations & group practices 4

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": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912114232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 523",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494290523",
            "telephone_number": "616-457-4919",
            "fax_number": "616-457-5261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29829 TELEGRAPH RD",
            "address_2": "SUITE 201",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341330",
            "telephone_number": "248-352-4263",
            "fax_number": "248-352-2915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNCO",
        "first_name": "LODIA",
        "middle_name": "A",
        "credential": "O.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201001703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.