Individual provider Active NPI

Elizabeth Anne Connell, OTR/L

  • Physical Rehabilitation Occupational Therapist
  • Riverdale, NJ
National Provider Identifier
1124773841
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X
License
46TR01036200 Issued in NJ
Practice address
7 Newark Pompton Tpke
Riverdale, NJ 07457-1142
Phone
(973) 831-1100
NPI assigned
Feb 22, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Rehabilitation Occupational Therapist 225XP0019X 46TR01036200 NJ Primary

Addresses

Primary practice location

7 Newark Pompton Tpke
Riverdale, NJ 07457-1142

Mailing address

7 Newark Pompton Tpke
Riverdale, NJ 07457-1142

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230113000806 NY Practitioner - Occupational Therapist in Private Practice 3678944485 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

303 S Broadway
Tarrytown, NY 10591-5413
Phone (914) 591-4332

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
46TR01036200NJMDPhysical Rehabilitation Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Dec 1, 2022 Accepting new patients
Cornerstone Chiropractic & Rehabilitation Center, LLC CurrentSince Feb 27, 2022 Accepting new patients
Montefiore Medical Center CurrentSince Dec 1, 2022 Accepting new patients
Cornerstone Medical Procedures LLC CurrentSince Feb 27, 2022 Accepting new patients
Kindelan Wellness, Inc. Past Accepting new patients

Locations

7 Newark Pompton Tpke
Riverdale, NJ 07457
Phone (973) 831-1100

111 E 210th St
Bronx, NY 10467

303 S Broadway
Tarrytown, NY 10591
Phone (914) 631-2022

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Organizations & group practices 5

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": "1645488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1124773841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 NEWARK POMPTON TPKE",
            "city": "RIVERDALE",
            "state": "NJ",
            "postal_code": "074571142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 NEWARK POMPTON TPKE",
            "city": "RIVERDALE",
            "state": "NJ",
            "postal_code": "074571142",
            "telephone_number": "973-831-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNELL",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-22",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "NJ",
            "license": "46TR01036200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverdale, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; 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.