Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Moshe R. Bantasan

Individual provider Occupational Therapist · NPI 1326585597

Moshe R. Bantasan is an Occupational Therapist in Private Practice in Springfield, Virginia. Qualified in 1999, 27 years ago. Practices with Functional Pathways Preferred of Tennessee LLC, a 192-clinician group and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
27
Licensed in
VA
In the registry since
2017
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Practice location Address checks out

7444 Shepherd Ridge Ct
Springfield, VA 22153-1908
Phone: (847) 271-2018
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 0119005124 (VA)

Record details

NPI number1326585597
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJanuary 26, 2017
Last updated in NPPESNovember 3, 2025
Certification dateNovember 3, 2025
Mailing address7444 Shepherd Ridge Ct, Springfield, VA 22153-1908

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1999 (27 years in practice)
Group practice Functional Pathways Preferred Of Tennessee Llc — 192 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Springfield