Jyotsna R Supnekar, OTR, CHT
Individual provider Active NPI Occupational Therapist · Abingdon, MD
NPI 1104034396 · NPPES record last updated Jul 18, 2011
Key facts
- NPI
- 1104034396
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 06635 (MD)
- Practice address
- 3465 Box Hill Corporate Center Dr
Suite G
Abingdon, MD 21009-1261 - Phone
- (410) 569-4806
- NPI assigned
- May 19, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Medicare Care Compare profile
- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Johns Hopkins Community Physicians, Inc
Practice addresses (Care Compare)
1000 E Eager St
E Baltimore Med Ctr
Baltimore, MD 21202-5533
Phone (410) 522-9800
4924 Campbell Blvd
Suite 130a
Nottingham, MD 21236-5909
Phone (443) 442-2800
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110907001129 | MD | Practitioner - Occupational Therapist in Private Practice | 7214107978 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06635 | MD | MD | Occupational Therapist |
| 46TR00154000 | NJ | MD | Hand Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Johns Hopkins Community Physicians | Current |
Accepting new patients | |
| Johns Hopkins Community Physicians | Current |
Accepting new patients | |
| Johns Hopkins Community Physicians, Inc | Current | Accepting new patients |
Locations
1000 E Eager St
Baltimore, MD 21202
Phone (410) 522-9800
6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 46TR00154000 | NJ | |
| Hand Occupational Therapist | 225XH1200X | 46TR00154000 | NJ | |
| Occupational Therapist | 225X00000X | 06635 | MD | Yes |
Addresses
Primary practice location
3465 Box Hill Corporate Center Dr
Suite G
Abingdon, MD 21009-1261
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223
Other providers in Abingdon, MD
- Angela N Stamidis
- Kellie Ann Stanley
- Stephanie Harding, DDS, P.C.
- Renee P Stokes
- Strategic Therapeutic Solutions
- Supreme Home Care Services Inc.
- Victoria Swift
- Mary Grace Tanguilan
- Sara Taylor
- Clare Thacker
All providers in Abingdon, MD · Occupational Therapist in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 18, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.