Individual provider Active NPI

Colleen Faede

  • Occupational Therapist
  • Westwood, NJ
National Provider Identifier
1053153288
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
46TR00872200 Issued in NJ
Practice address
99 Kinderkamack Rd Ste 100
Westwood, NJ 07675-3019
Phone
(201) 383-0826
NPI assigned
Jun 10, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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 46TR00872200 NJ Primary

Addresses

Primary practice location

99 Kinderkamack Rd Ste 100
Westwood, NJ 07675-3019

Mailing address

26 Glen CT
North Plainfield, NJ 07063-1719
Phone (908) 635-7661

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240707000165 NJ Practitioner - Occupational Therapist in Private Practice 5092259630 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
46TR00872200NJMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aim Neuro Rehab, LLC Occupational Therapist CurrentSince Jun 17, 2024 Accepting new patients

Locations

99 Kinderkamack Rd
Ste 100
Westwood, NJ 07675
Phone (201) 383-0826

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1717977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1053153288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 GLEN CT",
            "city": "NORTH PLAINFIELD",
            "state": "NJ",
            "postal_code": "070631719",
            "telephone_number": "908-635-7661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 KINDERKAMACK RD STE 100",
            "city": "WESTWOOD",
            "state": "NJ",
            "postal_code": "076753019",
            "telephone_number": "201-383-0826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAEDE",
        "first_name": "COLLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-10",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00872200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westwood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.