Individual provider Active NPI

Jessie Marie Perkovich, OTR

  • Occupational Therapist
  • Worcester, MA
National Provider Identifier
1083944698
Registry record updated Jan 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
9989 Issued in MA
Practice address
484 Main St
Worcester, MA 01608-1893
Phone
(508) 757-2756
NPI assigned
Jan 4, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2010

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 9989 MA Primary

Addresses

Primary practice location

484 Main St
Worcester, MA 01608-1893

Mailing address

484 Main St
Worcester, MA 01608-1893
Phone (508) 757-2756

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
9989MAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1262563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262563200000",
    "number": "1083944698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "484 MAIN ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081893",
            "telephone_number": "508-757-2756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "484 MAIN ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081893",
            "telephone_number": "508-757-2756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERKOVICH",
        "first_name": "JESSIE",
        "middle_name": "MARIE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-04",
        "last_updated": "2010-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "9989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2010; 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.