Individual provider Active NPI

Vanessa Grijalba, OTR/L

  • Occupational Therapist
  • Virginia Gardens, FL
National Provider Identifier
1013362243
Registry record updated Jan 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT17643 Issued in FL
Practice address
6555 NW 36TH St
Suite 106
Virginia Gardens, FL 33166-6978
Phone
(786) 615-9873
Fax
(789) 345-0620
NPI assigned
Apr 25, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT17643 FL Primary

Addresses

Primary practice location

6555 NW 36TH St
Suite 106
Virginia Gardens, FL 33166-6978

Mailing address

6555 NW 36TH St
Suite 106
Virginia Gardens, FL 33166-6978
Phone (786) 615-9873

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160815001386 FL Practitioner - Occupational Therapist in Private Practice 6305130394 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hands on Therapy Services, Inc.Group PAC ID 7618192329, 3 clinicians

Practice addresses (Care Compare)

7902 NW 36TH St
Suite 207
Doral, FL 33166-6663
Phone (786) 615-9879

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT17643FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rodrigo D. Rodriguez PastSince Jan 24, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1461542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642896000000",
    "number": "1013362243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6555 NW 36TH ST",
            "address_2": "SUITE 106",
            "city": "VIRGINIA GARDENS",
            "state": "FL",
            "postal_code": "331666978",
            "telephone_number": "786-615-9873",
            "fax_number": "789-345-0620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6555 NW 36TH ST",
            "address_2": "SUITE 106",
            "city": "VIRGINIA GARDENS",
            "state": "FL",
            "postal_code": "331666978",
            "telephone_number": "786-615-9873",
            "fax_number": "789-345-0620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIJALBA",
        "first_name": "VANESSA",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-25",
        "last_updated": "2022-01-23",
        "certification_date": "2022-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT17643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.