Individual provider Active NPI

Kyle Montalto, OTR/L

  • Occupational Therapist
  • Bellevue, WA
National Provider Identifier
1962159285
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT60840358 Issued in WA
Practice address
1115 108TH Ave NE
Bellevue, WA 98004-8655
Phone
(425) 279-5476
NPI assigned
Mar 7, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2022

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 OT60840358 WA Primary

Addresses

Primary practice location

1115 108TH Ave NE
Bellevue, WA 98004-8655

Mailing address

425 Vine St Apt 728
Seattle, WA 98121-1595
Phone (816) 668-9680

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220421000891 WA Practitioner - Occupational Therapist in Private Practice 4082001086 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empowerme Rehabilitation Wa PCGroup PAC ID 4284015330, 48 clinicians

Practice addresses (Care Compare)

2450 Newport Way NW
Issaquah, WA 98027-4046
Phone (425) 225-7282

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT60840358WAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Rehabilitation Wa, PC Occupational Therapist CurrentSince Jan 3, 2024 Accepting new patients

Locations

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

4503 S Freya St
Spokane, WA 99223
Phone (509) 472-8752

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": "1646611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1962159285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 VINE ST APT 728",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981211595",
            "telephone_number": "816-668-9680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 108TH AVE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980048655",
            "telephone_number": "425-279-5476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTALTO",
        "first_name": "KYLE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-07",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT60840358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; 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.