Kelly A. Bagdassian
NPI 1891061719ActiveIndividual· Occupational Therapist· Racine, WI
Occupational Therapist in Racine, Wisconsin, licensed in IL, with an NPI issued in March 2012. Enrolled in Medicare as practitioner - occupational therapist in private practice and practitioner - occupational therapist in private practice.
Overview
| NPI | 1891061719 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | Yes |
| NPI issued | Mar 25, 2012 |
| Last updated in NPPES | Mar 25, 2012 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Occupational Therapist Primary | 225X00000X | 056.006671 | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Occupational Therapist in Private Practice (IL); Practitioner - Occupational Therapist in Private Practice (WI) |
|---|
Education and affiliations
| Graduation year | 2000 |
|---|---|
| Medicare specialty | Occupational Therapist In Private Practice |
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