Individual provider Active NPI

Abigail Boette Srikanthan

  • Occupational Therapist
  • Madison, WI
National Provider Identifier
1982472437
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
8452-26 Issued in WI
Practice address
3113 W Beltline Hwy Ste 300
Madison, WI 53713-2934
Phone
(608) 819-6810
Fax
(224) 260-5160
NPI assigned
Dec 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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 8452-26 WI Primary

Addresses

Primary practice location

3113 W Beltline Hwy Ste 300
Madison, WI 53713-2934

Mailing address

1161 Lake Cook Rd
Deerfield, IL 60015-5649
Phone (224) 284-2240

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260410002180 WI Practitioner - Occupational Therapist in Private Practice 5294200838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1551 Aristides Blvd Apt
Suite 1102
Lexington, KY 40511-1671

228 Park Ave S
Suite 36053
New York, NY 10003-0103

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8452-26WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
KGH Consultation & Treatment, Inc. Occupational Therapist CurrentSince Dec 17, 2023 Accepting new patients
Children'S Therapy Network Occupational Therapist Past Accepting new patients

Locations

1161 Lake Cook Rd
Deerfield, IL 60015
Phone (224) 284-2240

3113 W Beltline Hwy
Ste 300
Madison, WI 53713
Phone (608) 819-6810

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": "1702512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1982472437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1161 LAKE COOK RD",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600155649",
            "telephone_number": "224-284-2240",
            "fax_number": "224-260-5160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3113 W BELTLINE HWY STE 300",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537132934",
            "telephone_number": "608-819-6810",
            "fax_number": "224-260-5160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRIKANTHAN",
        "first_name": "ABIGAIL",
        "middle_name": "BOETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-14",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "8452-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; 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.