Individual provider Active NPI

Vika Keonne Roque Tiamzon

  • Occupational Therapist
  • Somerset, NJ
National Provider Identifier
1043841323
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
46TR00898700 Issued in NJ
Practice address
1527 State Route 27 Ste 1100
Somerset, NJ 08873-3979
Phone
(732) 545-7474
NPI assigned
Jan 27, 2020
Last updated
Jan 27, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

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 46TR00898700 NJ Primary

Addresses

Primary practice location

1527 State Route 27 Ste 1100
Somerset, NJ 08873-3979

Mailing address

328 Sherman Ave
Roselle Park, NJ 07204-2141
Phone (908) 463-2908

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201103000921 NJ Practitioner - Occupational Therapist in Private Practice 3274943279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Varsha Pohuja LLCGroup PAC ID 8426346636, 43 clinicians

Practice addresses (Care Compare)

365 Ocean Blvd
Apt 302
Long Branch, NJ 07740-6408
Phone (732) 233-1107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
46TR00898700NJMDOccupational Therapist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1580083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1043841323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 SHERMAN AVE",
            "city": "ROSELLE PARK",
            "state": "NJ",
            "postal_code": "072042141",
            "telephone_number": "908-463-2908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1527 STATE ROUTE 27 STE 1100",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088733979",
            "telephone_number": "732-545-7474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIAMZON",
        "first_name": "VIKA KEONNE",
        "middle_name": "ROQUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-27",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00898700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; 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.