ANGIE LISSETTE BOLANOS-ESCALONA (OTR) – Occupational Therapist, NPI 1295057776

ANGIE LISSETTE BOLANOS-ESCALONA (OTR) is a healthcare provider. based in Fort lauderdale, Florida. specializing in OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials OTR. They hold a License No. 9463 (FL). The NPI Number for ANGIE LISSETTE BOLANOS-ESCALONA (OTR) is 1295057776

Main info

Female
Sole Proprietor
27 Years Of Experience
Accepts Medicare Assignment
Name
ANGIE LISSETTE BOLANOS-ESCALONA (OTR)
NPI
1295057776
Phone
(786) 348-6361
Address
15751 SHERIDAN ST
Enumeration Date
24 February 2010
Last Update Date
26 February 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7862590300
Graduation Year
1999 (27 years ago)
PAC ID
0547397051
Group Practice PAC ID
0840327342
Professional Enrollment ID
I20100414000746
Address ID
FL333283835DA4801XDRXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience56
Completeness85
Years active:16State licenses:1Digital endpointsOther names

1,139 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in FL

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Provider Addresses for ANGIE LISSETTE BOLANOS-ESCALONA (OTR)

  • 15751 SHERIDAN ST

    STE 162

    FORT LAUDERDALE, FL 333313486

    Phone: (786) 348-6361

    Fax: (866) 665-8671

    Type: Mailing

  • 1401, East 4th Avenue, Hialeah, Miami-Dade County, Florida, 33010, United States

    STE 204

    HIALEAH, FL 330103504

    Phone: (786) 348-6361

    Fax: (866) 665-8671

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-04-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100414000746IOccupational Therapist In Private PracticeFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes24613$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes12513$0
View full utilization report →

Insurance plans in this area (ZIP 33331)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0840327342View full group profile
NameSpecialtyState
-FL
Physical Therapist In Private PracticeFL
Occupational Therapist In Private PracticeFL
Physical Therapist In Private PracticeFL
Occupational Therapist In Private PracticeFL
Occupational Therapist In Private PracticeFL
Physical Therapist In Private PracticeFL
Physical Therapist In Private PracticeFL
Physical Therapist In Private PracticeFL
Occupational Therapist In Private PracticeFL

Reviews

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Frequently asked questions

Does ANGIE LISSETTE BOLANOS-ESCALONA (OTR) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — ANGIE LISSETTE BOLANOS-ESCALONA (OTR) uses 1295057776.
Does the file indicate ANGIE LISSETTE BOLANOS-ESCALONA (OTR) is practicing under active NPI?
Directory data currently reports ANGIE LISSETTE BOLANOS-ESCALONA (OTR) as active.
What is ANGIE LISSETTE BOLANOS-ESCALONA (OTR) best known for clinically?
Directory data describes ANGIE LISSETTE BOLANOS-ESCALONA (OTR) with Occupational Therapist. Clinical services aligned with this taxonomy classification.
Where should I expect ANGIE LISSETTE BOLANOS-ESCALONA (OTR) on a map?
Expect Fort Lauderdale, Florida as a primary anchor for ANGIE LISSETTE BOLANOS-ESCALONA (OTR) unless the record lists multiple sites.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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