Jillian Bucolo, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

46TR00575800 Issued in NJ

Practice address

106 Akron Ave
Haddon Township, NJ 08108-2408

Phone

(856) 316-8624

Fax

(856) 219-2407

NPI assigned

Dec 29, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jillian Gordon Former name

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community and Home Independence Partners LLCGroup PAC ID 1557710811, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Community & Home Independence Partners LLC

  • Occupational Therapist
  • Haddon Township, NJ
  • NPI 1376317123
  Medicare reassignment Care Compare group NPD Authorized official
• Bancroft, a New Jersey Nonprofit Corporation

  • Rehabilitation Clinic/Center
  • Cherry Hill, NJ
  • NPI 1720121106
  Medicare reassignment NPD
• Mobile Therapy Services, Inc.

  • Physical Therapist
  • Ocean, NJ
  • NPI 1326495615

  Occupational Therapist

  Medicare reassignment NPD
• Bancroft Neurohealth

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Mount Laurel, NJ
  • NPI 1598808941
  Medicare reassignment

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

{
    "created_epoch": "1451347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1033574561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 AKRON AVE",
            "city": "HADDON TOWNSHIP",
            "state": "NJ",
            "postal_code": "081082408",
            "telephone_number": "856-316-8624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 AKRON AVE",
            "city": "HADDON TOWNSHIP",
            "state": "NJ",
            "postal_code": "081082408",
            "telephone_number": "856-316-8624",
            "fax_number": "856-219-2407"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3900 Church Rd",
            "address_purpose": "LOCATION",
            "city": "Mount Laurel",
            "state": "NJ",
            "postal_code": "080541108",
            "country_code": "US",
            "telephone_number": "448-234-8387",
            "fax_number": "856-429-4755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCOLO",
        "first_name": "JILLIAN",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-29",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00575800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILLIAN",
            "last_name": "GORDON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Carolanne Brennan, LCADC
• Maria Brent, LPC
• Janice S Britt-Meadows, MSW, LSW
• Tara L Brophy, MSW
• Sara Mounier Brummer, PT, DPT
• Jonathan Burns, PHARMD
• Suzanne Carney, L.C.S.W.
• Anne M Cavaliere, LPC
• Larry S Charles Jr.
• Laura Choi

• Occupational Therapist in Haddon Township, NJ
• Providers in Haddon Township, NJ by specialty
• Occupational Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.