Active NPI
Ana K Bocanegra
- Occupational Therapist
- Grand Rapids, MI
National Provider Identifier
1942728027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5201009898
- Practice address
- 1490 E Beltline Ave SE
Grand Rapids, MI 49506-4336 - Phone
- (616) 214-9754
- NPI assigned
- Sep 8, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 5201009898 | MI | Primary |
Addresses
Primary practice location
1490 E Beltline Ave SE
Grand Rapids, MI 49506-4336
Mailing address
1490 E Beltline Ave SE
Grand Rapids, MI 49506-4336
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942728027 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5201009898 | MI | MD | Occupational Therapist |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
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- Grand Rapids, MI
- NPI 1528043544
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555545600000",
"number": "1942728027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1490 E BELTLINE AVE SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495064336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1490 E BELTLINE AVE SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495064336",
"telephone_number": "616-214-9754"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOCANEGRA",
"first_name": "ANA",
"middle_name": "K",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-08",
"last_updated": "2019-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MI",
"license": "5201009898",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1942728027",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.