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

MS. Kelly A Bagdassian

Individual provider Occupational Therapist · NPI 1891061719

MS. Kelly A Bagdassian is an Occupational Therapist in Private Practice in Racine, Wisconsin. Qualified in 2000, 26 years ago. Practices as a sole proprietor. Licensed in Illinois.

Years since qualifying
26
Licensed in
IL
In the registry since
2012

Practice location Address checks out

1302 Melvin Ave
Racine, WI 53402-4150
Phone: (262) 412-8320
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 056.006671 (IL)

Record details

NPI number1891061719
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMarch 25, 2012
Last updated in NPPESMarch 25, 2012

Medicare enrollment

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

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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