Professional Occupational & Physical Therapy, PLLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

PROFESSIONAL OCCUPATIONAL & PHYSICAL THERAPY, PLLC

Practice address

112 Bloomfield Ave
Caldwell, NJ 07006-5336

Phone

(973) 226-2434

Fax

(973) 226-3010

NPI assigned

Sep 14, 2016

Organization subpart

No

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

Authorized official

Name

Kathleen Brush

Title

Credentialing Coordinator

Phone

(718) 819-6805

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matthew Lopes

  • Physical Therapist
  • Lyndhurst, NJ
  • NPI 1053813394
  NPD

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

{
    "created_epoch": "1473811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522195200000",
    "number": "1154879500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002",
            "telephone_number": "631-359-5859",
            "fax_number": "631-396-0865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 BLOOMFIELD AVE",
            "city": "CALDWELL",
            "state": "NJ",
            "postal_code": "070065336",
            "telephone_number": "973-226-2434",
            "fax_number": "973-226-3010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL OCCUPATIONAL & PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-14",
        "last_updated": "2018-03-28",
        "status": "A",
        "authorized_official_last_name": "BRUSH",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "718-819-6805"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Precision Vision
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• Cynthia R Prestigiacomo, MD
• Prime Arthritis and Rheumatology Center LLC
• Princeton Behavioral Associates, LLC
• Professional Orthopedic and Sports Physical Therapy of NJ, LLC
• Penelope B. Prosperi, MSW
• Jennifer Ra, PSYD
• Bayan Rafee, DDS
• Marcus Regino, LAC

• Occupational Therapist in Caldwell, NJ
• Providers in Caldwell, NJ by specialty
• Occupational Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2018; 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.

Verify at the official NPI Registry.