Individual provider Active NPI

Alexis Catherine Caccio, OTR/L

  • Occupational Therapist
  • Havertown, PA
National Provider Identifier
1013674811
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OC018040 Issued in PA
Practice address
2010 W Chester Pike Ste 425
Havertown, PA 19083-2740
Phone
(610) 789-9815
NPI assigned
Nov 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 46TR01026400 NJ
Occupational Therapist 225X00000X OC018040 PA Primary

Addresses

Primary practice location

2010 W Chester Pike Ste 425
Havertown, PA 19083-2740

Mailing address

PO Box 34990
Belfast, ME 04915-0627

Other practice location 1

3338 Route 9 S
Freehold, NJ 07728-9148
Phone (732) 780-1111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220112000059 NJ Practitioner - Occupational Therapist in Private Practice 2466844006 Reassigns benefits to 1 organization
I20240705000790 PA Practitioner - Occupational Therapist in Private Practice 2466844006 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2010 W Chester Pike
Suite 425
Havertown, PA 19083-2740
Phone (610) 789-9815

Merit-based Incentive Payment System (MIPS)

Final score
96.6 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
46TR01026400NJMDOccupational Therapist
OC018040PAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Wellness CurrentSince Nov 30, 2021 Accepting new patients
Premier Orthopaedic and Sports Medicine Associates, LTD CurrentSince Jun 24, 2024 Accepting new patients
Premier Orthopaedic and Sports Medicine Associates LTD Occupational Therapist CurrentSince Jun 24, 2024 Accepting new patients
Orthopedic Sports & Arthritis Surgery Past Accepting new patients

Locations

3338 US Highway 9
Freehold, NJ 07728
Phone (732) 780-1111

17 N Main St
Marlboro, NJ 07746
Phone (732) 431-2155

2004 Sproul Rd
Fl 1
Broomall, PA 19008
Phone (610) 353-0800

2010 W Chester Pike
Ste 425
Havertown, PA 19083
Phone (610) 449-3265

2600 Easton Rd
Willow Grove, PA 19090
Phone (610) 768-1610

Organizations & group practices 4

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": "1638144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1013674811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34990",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049150627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 W CHESTER PIKE STE 425",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190832740",
            "telephone_number": "610-789-9815"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3338 Route 9 S",
            "address_purpose": "LOCATION",
            "city": "Freehold",
            "state": "NJ",
            "postal_code": "077289148",
            "country_code": "US",
            "telephone_number": "732-780-1111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CACCIO",
        "first_name": "ALEXIS",
        "middle_name": "CATHERINE",
        "name_prefix": "Miss",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-29",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR01026400",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC018040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Havertown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; 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.