CMS-1500 Box 24J / 33a • NPI
1932066404
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
225XR0403X (CMS 67)
Board-Certified Occupational Therapist (OTR/L — Functional & Daily Living Rehab)
Box 32 Service Location & ZIP+4
19 ROBINSON RD, CLINTON, NY, 13323-1418
✓ 9-Digit EDI 837 ZIP+4 (13323-1418)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1932066404 (KENDRA BERGERON) 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
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1932066404 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | KENDRA BERGERON |
| Plain-English Specialty | Board-Certified Occupational Therapist (OTR/L — Functional & Daily Living Rehab) NUCC Code: 225XR0403X (Occupational Therapist, Driving and Community Mobility) |
| Certifying / Licensing Body | National Board for Certification in Occupational Therapy (NBCOT) |
| Practice Location Address | 19 ROBINSON RD, CLINTON, NY, 13323-1418 |
| Practice Telephone / Fax | Tel: (315) 853-6090 |
| Administrative Mailing Address | 2522 VAN DYKE AVE, SCHENECTADY, NY, 12306-3834 |
| Enumeration & Last Sync | Enumerated: 2026-01-07 | CMS Record Updated: 2026-01-07 |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (225XR0403X)
What Does Taxonomy Code 225XR0403X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 225XR0403X translates to:
"Board-Certified Occupational Therapist (OTR/L — Functional & Daily Living Rehab)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (KENDRA BERGERON)
Typical CPT / Diagnostic Procedures:- Activities of Daily Living (ADL) & Neuromuscular Re-Education (CPT 97530–97535)
- Upper Extremity Hand Therapy, Custom Splinting & Home Safety Ergonomics
- Non-Pharmacological Functional & Sensory-Motor Rehabilitation Protocols
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
225XR0403X — Occupational Therapist, Driving and Community MobilityPlain English: Board-Certified Occupational Therapist (OTR/L — Functional & Daily Living Rehab) | State: NY | License: 030785 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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