Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1508063645 Individual Practitioner Male Practitioner

Shane Michael Disheaux , COTA

Occupational Therapy Assistant • Fort Wayne, IN

Professional Overview & Biography Verified Profile Summary

Shane Disheaux, COTA is a registered healthcare professional specializing in Occupational Therapy Assistant in Fort Wayne, IN. Practice services are available at 2827 NORTHGATE BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2827 Northgate Blvd

Fort Wayne, IN 468352903

Telephone 2604921498
Fax 2604921674
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Occupational Therapy Assistant in Fort Wayne, IN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 35.0 Yrs
Regional Practice Density
119 Specialists

Practicing in Fort Wayne, IN (1107 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Occupational Therapy Assistant Primary Specialty

NUCC Taxonomy Code: 224Z00000X

State License IN 32001345A

An occupational therapy assistant is a person who has graduated from an occupational therapy assistant program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, has successfully completed a period of supervised fieldwork experience required by the accredited occupational therapy assistant program, has passed a nationally recognized entry-level examination for occupational therapy assistants, and fulfills state requirements for licensure, certification, or registration. An occupational therapy assistant provides interventions under the supervision of an occupational therapist which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapy assistants address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
1555-656 (IN)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

7 Associated Practitioners
Marroh Espinosa , PT

Physical Therapist

NPI 1366649402

Physical Therapist

David Niner , SLP

Speech-Language Pathologist

NPI 1437356904

Speech-Language Pathologist

Pearl Padrique , RPT

Physical Therapist

NPI 1780882514

Registered Physical Therapist

Tracey Gordon

Physical Therapy Assistant

NPI 1801144464
Anthony Panbamrung , PTA

Physical Therapy Assistant

NPI 1861699092

Physical Therapist Assistant

Christina Smith , PTA

Physical Therapy Assistant

NPI 1871790907

Physical Therapist Assistant

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 2827 NORTHGATE BLVD, FORT WAYNE, IN 468352903 (Tel: 2604921498)

📍
Updated Business Mailing Address July 08, 2007

Registered at 5305 WOODWAY DR, FORT WAYNE, IN 468353676 (Tel: 2604922027)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as SHANE DISHEAUX, COTA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Occupational Therapy Assistant (License #32001345A in IN)

🟢
Initial NPI Registration & Enumeration July 02, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1508063645
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 02, 2007
Last Update: July 08, 2007
Sole Proprietor: No

Mailing Address

5305 Woodway Dr

Fort Wayne, IN 468353676

Phone: 2604922027

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.