Active NPI
Edita Jancauskas
- Occupational Therapist
- Port St Lucie, FL
National Provider Identifier
1124315874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT14561
- Practice address
- 2125 SW Susset LN
Port St Lucie, FL 34953-2300 - Phone
- (708) 717-4266
- NPI assigned
- Jul 1, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT14561 | FL | Primary |
Addresses
Primary practice location
2125 SW Susset LN
Port St Lucie, FL 34953-2300
Mailing address
2125 SW Susset LN
Port St Lucie, FL 34953-2300
Phone (708) 717-4266
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT14561 | FL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sobe Innovative Rehabilitation PLLC | Occupational Therapist | Current | Accepting new patients |
Locations
2777 NE 183rd St
Aventura, FL 33160
Phone (305) 405-2014
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.
-
- Physical Therapist
- Miami, FL
- NPI 1164800595
Occupational Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309478400000",
"number": "1124315874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2125 SW SUSSET LN",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349532300",
"telephone_number": "708-717-4266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2125 SW SUSSET LN",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349532300",
"telephone_number": "708-717-4266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JANCAUSKAS",
"first_name": "EDITA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-07-01",
"last_updated": "2011-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "OT14561",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port St Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2011; 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.