KATHRYN BRODERIUS, MOT — NPI 1154074508 (Board-Certified Occupational Therapist (OTR/L — Functional & Daily Living Rehab) in MIDDLETON, ID)

CMS-1500 Box 24J / 33a • NPI

1154074508

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

225X00000X (CMS 67)

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

Box 32 Service Location & ZIP+4

316 E 1ST ST, MIDDLETON, ID, 83644-6159

✓ 9-Digit EDI 837 ZIP+4 (83644-6159)

Practice Phone & Referral Fax

(208) 654-6161

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1154074508 (KATHRYN BRODERIUS, MOT) 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	`1154074508` (NPI-1 Individual Practitioner)
Provider / Legal Name	KATHRYN BRODERIUS, MOT
Plain-English Specialty	Board-Certified Occupational Therapist (OTR/L — Functional & Daily Living Rehab) NUCC Code: `225X00000X` (Occupational Therapist)
Certifying / Licensing Body	National Board for Certification in Occupational Therapy (NBCOT)
Practice Location Address	316 E 1ST ST, MIDDLETON, ID, 83644-6159
Practice Telephone / Fax	Tel: (208) 654-6161
Administrative Mailing Address	3700 E DOWNS AVE, NAMPA, ID, 83686-1385
Enumeration & Last Sync	Enumerated: 2022-01-26 \| CMS Record Updated: 2022-01-26

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

316 E 1ST ST, MIDDLETON, ID, 83644-6159

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Plain-English Taxonomy & CMS Crosswalk (225X00000X)

What Does Taxonomy Code 225X00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 225X00000X 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 (KATHRYN BRODERIUS, MOT)

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
`225XP0200X` — Occupational Therapist, Pediatrics Plain English: Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)	State: ID \| License: `OT-2455` \| Primary: Secondary
`225X00000X` — Occupational Therapist Plain English: Board-Certified Occupational Therapist (OTR/L — Functional & Daily Living Rehab)	State: ID \| License: `OT-2455` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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KATHRYN BRODERIUS, MOT (NPI #1154074508)