Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Thomas Masashi Ikeda, OTRL

Individual provider Occupational Therapist · NPI 1891751889

Mr. Thomas Masashi Ikeda, OTRL is an Occupational Therapist in Private Practice in Waco, Texas. Qualified in 2002, 24 years ago. Practices with Active Therapy Group LLC, an 8-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
24
Licensed in
TX
In the registry since
2006
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Practice location Address checks out

1200 Richland Dr Ste G
Waco, TX 76710-8008
Phone: (254) 772-0118
Fax: (254) 772-3883
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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 111726 (TX)

Record details

NPI number1891751889
Entity typeIndividual (Type 1)
GenderMale
Credentials OTRL
Sole proprietorNo
NPI enumeratedApril 26, 2006
Last updated in NPPESJuly 8, 2007

Medicare enrollment

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

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Group practice Active Therapy Group Llc — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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