Jacqueline Amanda Colli, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

46TR00932100 Issued in NJ

Practice address

1868 Hooper Ave
Toms River, NJ 08753-8175

Phone

(347) 668-6367

NPI assigned

Aug 5, 2020

Last updated

Nov 20, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Maximum Wellness Rehabilitation Center LLCGroup PAC ID 7214296029, 8 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Maximum Wellness Rehabilitation Center LLC

  • Physical Therapist
  • Toms River, NJ
  • NPI 1285147017
  Medicare reassignment Care Compare group
• Freehold Health and Wellness LLC

  dba Infinity health and wellness

  • Chiropractor
  • Freehold, NJ
  • NPI 1982058608

  Occupational Therapist

  Medicare reassignment NPD
• Menon Regenerative Institute LLC

  • Specialist
  • Millburn, NJ
  • NPI 1306317789
  NPD (past)

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

{
    "created_epoch": "1596585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1043820012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 FOSTER RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103092247",
            "telephone_number": "347-668-6367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1868 HOOPER AVE",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087538175",
            "telephone_number": "347-668-6367"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 Central Ave Ste 145",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925062161",
            "country_code": "US",
            "telephone_number": "951-297-3399",
            "fax_number": "909-890-4393",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "802 Magnolia Ave Ste 107",
            "address_purpose": "LOCATION",
            "city": "Corona",
            "state": "CA",
            "postal_code": "928793125",
            "country_code": "US",
            "telephone_number": "951-340-0070",
            "fax_number": "909-890-4393",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1845 Business Center Dr Ste 127",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924083434",
            "country_code": "US",
            "telephone_number": "909-890-9030",
            "fax_number": "909-890-4393",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "545 Foster Rd",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103092247",
            "country_code": "US",
            "telephone_number": "347-668-6367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLI",
        "first_name": "JACQUELINE",
        "middle_name": "AMANDA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-05",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "024139-01",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "21482",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00932100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cole Vision Corporation (Sears Optical #C1025)
• Devon Cole, MD
• Jamal Cole, MD
• Michele Cole
• Joseph Colford, PHD
• Jill A Collier, M.D.
• Gilbert Collot
• Colts Neck Neurology,PA
• Thomas Robert Comerci, M.D.
• Donna Comerford, LCSW

• Occupational Therapist in Toms River, NJ
• Providers in Toms River, 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 Nov 20, 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.