TYLER ICHIKI OTR/L
NPI 1902625825
Occupational Therapist - Hand in Gresham, OR
About Tyler Ichiki Otr/l NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TYLER ICHIKI OTR/L (NPI 1902625825) is an individual hand provider in Gresham, Oregon, licensed in Oregon (505784) and active in the NPI registry since October 2024. He is a graduate of Other (2023).
NPPES Registry Identity
Specialties & Licenses
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
Tyler Ichiki Otr/l 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.
Medicare Billing Reassignment
Medicare enrollment records show Tyler Ichiki reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Beaverton, OR 97006
- Reassigned Medicare billing, Oregon enrollment
- 46 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 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
GRESHAM, OR 97030
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 Tyler Ichiki's NPI number?
The NPI number for Tyler Ichiki is 1902625825. It was assigned to this individual provider in the NPPES registry on October 8, 2024.
Where is Tyler Ichiki located?
Tyler Ichiki practices at 24076 SE Stark St Ste 210, Gresham, OR 97030. The listed phone number is (503) 491-1666.
What is Tyler Ichiki's specialty?
The primary specialty registered for this NPI is Occupational Therapist, specializing in Hand, with taxonomy code 225XH1200X.
Is Tyler Ichiki enrolled in Medicare?
Yes. Tyler Ichiki 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 Tyler Ichiki's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Tyler Ichiki reassigns Medicare benefits to Sportscare Physical Therapy @ Cornell, LLC (Beaverton, OR). 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 Tyler Ichiki's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Tyler Ichiki accept?
Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans and Regence BlueCross BlueShield of Oregon list Tyler Ichiki 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 Tyler Ichiki was last updated on October 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.
# Tyler Ichiki, OTR/L · NPI 1902625825
Hand provider in Gresham, Oregon. Individual provider, active in the CMS NPPES registry since October 8, 2024.
## Identity
- **NPI:** 1902625825 (Entity type: Individual)
- **Enumerated:** October 8, 2024
- **Primary specialty:** Occupational Therapist - Hand · taxonomy 225XH1200X
- **State license:** 505784 (Oregon)
- **Sole proprietor:** No
## Practice location
- **Address:** 24076 SE STARK ST STE 210, Gresham, OR 97030-3376
- **Phone:** (503) 491-1666
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** Sportscare Physical Therapy @ Cornell, LLC (NPI 1649534793, Beaverton, OR), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** October 8, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1902625825) · Data from the CMS NPPES public registry.