AYUMI GOTHBERG
NPI 1710836937
Occupational Therapist in Shoreline, WA

Active since January 22, 2026Accepts Medicare Assignment
14900 1ST AVE NE, SHORELINE, WA 98155(206) 279-3448 Get Directions Write a Review

NPPES record last updated: January 22, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Ayumi Gothberg NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AYUMI GOTHBERG (NPI 1710836937) is an individual occupational therapist in Shoreline, Washington, licensed in Washington (OT.OT.70052251) and active in the NPI registry since January 2026. She maintains 2 additional practice locations and is a graduate of Other (2022).

NPPES Registry Identity

NPI1710836937
Entity TypeIndividualFemale
Primary Taxonomy225X00000X
Provider Legal NameAYUMI GOTHBERG
Location Address14900 1ST AVE NEShoreline, WA 98155-6800
Mailing Address2613 Nw 86th StSeattle, WA 98117-3838
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateJanuary 22, 2026
NPPES CertifiedJanuary 22, 2026
✔ NPI 1710836937 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225X00000X
License✔ Licensed in WA · OT.OT.70052251
Definition
An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and 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 therapists 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.
14900 1ST AVE NE, Shoreline, WA 98155

Secondary Practice Locations 2

Location 110000 Holman Rd NWSeattle, WA 98177-4959 · Phone (262) 202-4588
Location 23200 NE 45th StSeattle, WA 98105-5604 · Phone (206) 823-1332

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ayumi Gothberg is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7911486667
PECOS Enrollment IDI20260212000795

Medicare Billing Reassignment

Medicare enrollment records show Ayumi Gothberg reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Multi-Specialty
2450 NEWPORT WAY NW
Issaquah, WA 98027
  • Reassigned Medicare billing, Washington enrollment
  • 51 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Therapy Assistant
14900 1ST AVE NE
SHORELINE, WA 98155
Occupational Therapist
14900 1ST AVE NE
SHORELINE, WA 98155
Physical Therapist
14900 1ST AVE NE
SHORELINE, WA 98155
Physical Therapist
14900 1ST AVE NE
SHORELINE, WA 98155
Occupational Therapist
14900 1ST AVE NE
SHORELINE, WA 98155

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ayumi Gothberg's NPI number?

The NPI number for Ayumi Gothberg is 1710836937. It was assigned to this individual provider in the NPPES registry on January 22, 2026.

Where is Ayumi Gothberg located?

Ayumi Gothberg practices at 14900 1st Ave NE, Shoreline, WA 98155. The listed phone number is (206) 279-3448.

What is Ayumi Gothberg's specialty?

The primary specialty registered for this NPI is Occupational Therapist with taxonomy code 225X00000X.

Is Ayumi Gothberg enrolled in Medicare?

Yes. Ayumi Gothberg is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Ayumi Gothberg's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ayumi Gothberg reassigns Medicare benefits to Empowerme Rehabilitation Wa, PC (Issaquah, WA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ayumi Gothberg's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ayumi Gothberg accept?

Health plans from PacificSource Health Plans list Ayumi Gothberg as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Ayumi Gothberg was last updated on January 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.