TRACEY L AIRTH-EDBLOM, OTR/L, CHT — NPI 1053571307 (Board-Certified Occupational Therapist (OTR/L — Functional & Daily Living Rehab) in PETALUMA, CA)

CMS-1500 Box 24J / 33a • NPI

1053571307

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

225XH1200X (CMS 67)

Board-Certified Occupational Therapist (OTR/L — Functional & Daily Living Rehab)

Box 32 Service Location & ZIP+4

226 WELLER ST, PETALUMA, CA, 94952-3136

✓ 9-Digit EDI 837 ZIP+4 (94952-3136)

Practice Phone & Referral Fax

(707) 762-7678

Fax: (707) 762-7679

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1053571307 (TRACEY L AIRTH-EDBLOM, OTR/L, CHT) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1053571307` (NPI-1 Individual Practitioner)
Provider / Legal Name	TRACEY L AIRTH-EDBLOM, OTR/L, CHT
Plain-English Specialty	Board-Certified Occupational Therapist (OTR/L — Functional & Daily Living Rehab) NUCC Code: `225XH1200X` (Occupational Therapist, Hand)
Certifying / Licensing Body	National Board for Certification in Occupational Therapy (NBCOT)
Practice Location Address	226 WELLER ST, PETALUMA, CA, 94952-3136
Practice Telephone / Fax	Tel: (707) 762-7678 \| Fax: (707) 762-7679
Administrative Mailing Address	8 PACIFIC DR, NOVATO, CA, 94949-5479
Enumeration & Last Sync	Enumerated: 2008-06-11 \| CMS Record Updated: 2008-06-11

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

226 WELLER ST, PETALUMA, CA, 94952-3136

🗺️ Open in Google Maps 🏥 More Providers in PETALUMA

🔒 Are you TRACEY L AIRTH-EDBLOM, OTR/L, CHT? Get your Verified NPI Clinic Badge or request personal phone/address redaction →

Plain-English Taxonomy & CMS Crosswalk (225XH1200X)

What Does Taxonomy Code 225XH1200X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 225XH1200X translates to:
"Board-Certified Occupational Therapist (OTR/L — Functional & Daily Living Rehab)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 67 (Occupational Therapist in Private Practice)
Certifying / Accrediting Authority: National Board for Certification in Occupational Therapy (NBCOT)
Clinical Scope: Regaining hand function, fine motor skills, and independent daily living after stroke, hand injury, or pediatric developmental delay.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (TRACEY L AIRTH-EDBLOM, OTR/L, CHT)

Typical CPT / Diagnostic Procedures:

Activities of Daily Living (ADL) & Neuromuscular Re-Education (CPT 97530–97535)
Upper Extremity Hand Therapy, Custom Splinting & Home Safety Ergonomics

Common Therapeutic Classes:

Non-Pharmacological Functional & Sensory-Motor Rehabilitation Protocols

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`225XH1200X` — Occupational Therapist, Hand Plain English: Board-Certified Occupational Therapist (OTR/L — Functional & Daily Living Rehab)	State: CA \| License: `OT345` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

Batch-verify up to 25 NPIs free against CMS NPPES + Medicare PECOS + HHS OIG Exclusions with 1-click CSV export.

Launch Bulk NPI Checker → JSON API Docs

TRACEY L AIRTH-EDBLOM, OTR/L, CHT (NPI #1053571307)