NPIMap

Individual provider Active NPI

Nicole Elizabeth Boyington, OTD

  • Occupational Therapist
  • Waukesha, WI
National Provider Identifier
1962779116
Registry record updated May 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
3773-026 Issued in WI
Practice address
1180 Pioneer TRL
Waukesha, WI 53186-5490
Phone
(262) 226-2050
NPI assigned
Nov 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2020

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Environmental Modification Occupational Therapist 225XE0001X
Gerontology Occupational Therapist 225XG0600X
Mental Health Occupational Therapist 225XM0800X
Physical Rehabilitation Occupational Therapist 225XP0019X
Pediatric Occupational Therapist 225XP0200X
Occupational Therapist 225X00000X 3773-026 WI Primary

Addresses

Primary practice location

1180 Pioneer TRL
Waukesha, WI 53186-5490

Mailing address

1180 Pioneer TRL
Waukesha, WI 53186-5490
Phone (262) 226-2050

Other practice location 1

1625 Coldwater Creek Dr
Waukesha, WI 53188-8028
Phone (262) 251-8800

Other names 1

  • Nicole Elizabeth Glisczinski Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
3773-026WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Living Well Occupational Therapy, LLC Occupational Therapist Current Accepting new patients
Dyslexia Achievement Center, LLC Occupational Therapist Current Accepting new patients
Occupational Therapy Family Services, LLC CurrentSince Jun 14, 2020 Accepting new patients

Organizations & group practices 3

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": "1321401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589846400000",
    "number": "1962779116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 PIONEER TRL",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531865490",
            "telephone_number": "262-226-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 PIONEER TRL",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531865490",
            "telephone_number": "262-226-2050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1625 Coldwater Creek Dr",
            "address_purpose": "LOCATION",
            "city": "Waukesha",
            "state": "WI",
            "postal_code": "531888028",
            "country_code": "US",
            "telephone_number": "262-251-8800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOYINGTON",
        "first_name": "NICOLE",
        "middle_name": "ELIZABETH",
        "credential": "OTD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-16",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XE0001X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Environmental Modification",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XM0800X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "3773-026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "GLISCZINSKI",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2020; 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.