Individual provider Active NPI

Elyana Marissa Gonzalez

  • Occupational Therapist
  • Clifton, NJ
National Provider Identifier
1013676980
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
026223 Issued in NY
Practice address
1003 Main Ave
Clifton, NJ 07011-2333
Phone
(201) 344-2499
NPI assigned
Dec 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 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 46TR01119700 NJ
Occupational Therapist 225X00000X 026223 NY Primary

Addresses

Primary practice location

1003 Main Ave
Clifton, NJ 07011-2333

Mailing address

125 Belmar Ter
Westfield, NJ 07090-2247
Phone (516) 524-0817

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
46TR01119700NJMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Reddy Care Physical and Occupational Therapy PLLC CurrentSince Dec 8, 2021 Accepting new patients
New York Physical and Occupational Therapy Services, PLLC Occupational Therapist CurrentSince May 16, 2023 Accepting new patients
Ignite Rehab Corp Occupational Therapist CurrentSince Jan 14, 2024 Accepting new patients
Reddy Care Physical Therapy PC PastSince Dec 1, 2021 Accepting new patients

Locations

1003 Main Ave
Clifton, NJ 07011
Phone (201) 344-2499

2579 Ocean Ave
Fl 3
Brooklyn, NY 11229
Phone (646) 780-0925

475 Northern Blvd
Ste 27
Great Neck, NY 11021

475 Northern Blvd
Ste 19
Great Neck, NY 11021
Phone (516) 344-0023

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": "1638921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1013676980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 BELMAR TER",
            "city": "WESTFIELD",
            "state": "NJ",
            "postal_code": "070902247",
            "telephone_number": "516-524-0817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 MAIN AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070112333",
            "telephone_number": "201-344-2499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "ELYANA",
        "middle_name": "MARISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-08",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR01119700",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "026223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.