Jackie Lynn Orta, OTD, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201008390 Issued in MI

Practice address

2333 Biddle Ave
Wyandotte, MI 48192-4668

Phone

(734) 246-6000

NPI assigned

Mar 29, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Shoreline Clinic LLCGroup PAC ID 6507214061, 3 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 and National Provider Directory roles.

• The Shoreline Clinic, LLC

  • Physical Therapist
  • Sarasota, FL
  • NPI 1265118632
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1093210239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 BIDDLE AVE",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481924668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 BIDDLE AVE",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481924668",
            "telephone_number": "734-246-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTA",
        "first_name": "JACKIE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-29",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201008390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jorta9330@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "2333 Biddle Ave",
            "city": "Wyandotte",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481924668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Toni C Ochs, RDH
• Melanie Gwen Odell
• Hailey Kristine Olds, MD
• Daniel W Olenchak, DO
• Optimum Pathology Services PLLC
• Timothy Lee Otto, D.O.
• Leo D. Ottoni, M.D.
• Out of Ashes LLC
• P.T. Plus Therapeutic Resources, Inc.
• Andrea Bree Panichella, PTA

• Occupational Therapist in Wyandotte, MI
• Providers in Wyandotte, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2021; 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.