Individual provider Active NPI

Jessie Maria Hoffman, COTA

  • Occupational Therapy Assistant
  • New Berlin, WI
National Provider Identifier
1093010589
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
4700-27 Issued in WI
Practice address
2725 S Moorland Rd
Ste 301
New Berlin, WI 53151
Phone
(414) 329-2500
NPI assigned
Jan 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 4700-27 WI Primary

Addresses

Primary practice location

2725 S Moorland Rd
Ste 301
New Berlin, WI 53151

Mailing address

1505 Orrin Rd
Prescott, WI 54021-1074
Phone (715) 262-1107

Other names 1

  • Jessie Maria Hennemann Hoffman Former name

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
4700-27WIMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mjcare, Inc. CurrentSince Feb 25, 2024 Accepting new patients

Locations

2725 S Moorland Rd
Ste 301
New Berlin, WI 53151
Phone (414) 329-2428

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": "1294963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1093010589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 ORRIN RD",
            "city": "PRESCOTT",
            "state": "WI",
            "postal_code": "540211074",
            "telephone_number": "715-262-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 S MOORLAND RD",
            "address_2": "STE 301",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "53151",
            "telephone_number": "414-329-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFFMAN",
        "first_name": "JESSIE",
        "middle_name": "MARIA",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-14",
        "last_updated": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "4700-27",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSIE",
            "last_name": "HENNEMANN HOFFMAN",
            "middle_name": "MARIA",
            "credential": "COTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Berlin, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; 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.