Individual provider Active NPI

Regan Kaelle Liss, OT

  • Occupational Therapist
  • Scottsdale, AZ
National Provider Identifier
1962265421
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTH-009566 Issued in AZ
Practice address
10304 N Hayden Rd Ste 115
Scottsdale, AZ 85258-1218
Phone
(480) 429-5266
Fax
(480) 429-5297
NPI assigned
Feb 6, 2024
Last updated
Apr 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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 OTH-009566 AZ Primary

Addresses

Primary practice location

10304 N Hayden Rd Ste 115
Scottsdale, AZ 85258-1218

Mailing address

1860 N 95TH LN Ste 105
Phoenix, AZ 85037-4333
Phone (480) 429-5266

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240326000263 AZ Practitioner - Occupational Therapist in Private Practice 5193162204 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7165 E University Dr
Suite 143
Mesa, AZ 85207-6411
Phone (480) 218-9973

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OTH-009566AZMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
DHT Hand Therapy Limited Partnership Physical Therapist CurrentSince Mar 6, 2024 Accepting new patients
DHT Hand Therapy Limited Partnership Occupational Therapist CurrentSince Mar 6, 2024 Accepting new patients
Arizona Center for Hand Surgery PC CurrentSince Sep 26, 2024 Accepting new patients
DHT Hand Therapy Limited Partnership Physical Therapist Current Accepting new patients
Arizona Center for Hand Surgery PC CurrentSince Sep 26, 2024 Accepting new patients

Locations

2195 W Chandler Blvd
Ste 180
Chandler, AZ 85224
Phone (480) 963-9339

5757 W Thunderbird Rd
Ste E465
Glendale, AZ 85306
Phone (602) 393-4263

1520 S Dobson Rd
Ste 210
Mesa, AZ 85202
Phone (480) 898-8593

7165 E University Dr
Ste 143
Mesa, AZ 85207
Phone (480) 218-9973

15830 N 35th Ave
Ste 1
Phoenix, AZ 85053
Phone (602) 298-1188

1860 N 95th Ln
Ste 105
Phoenix, AZ 85037
Phone (623) 907-0828

3329 E Bell Rd
Ste A5
Phoenix, AZ 85032

370 E Virginia Ave
Ste 1
Phoenix, AZ 85004

370 E Virginia Ave
Ste 100
Phoenix, AZ 85004
Phone (602) 200-8988

10304 N Hayden Rd
Ste 115
Scottsdale, AZ 85258
Phone (480) 429-5266

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1707177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1962265421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 N 95TH LN STE 105",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850374333",
            "telephone_number": "480-429-5266",
            "fax_number": "480-429-5297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10304 N HAYDEN RD STE 115",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852581218",
            "telephone_number": "480-429-5266",
            "fax_number": "480-429-5297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISS",
        "first_name": "REGAN",
        "middle_name": "KAELLE",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-06",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "OTH-009566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; 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.