Individual provider Active NPI

Suzanne Hall, OT

  • Occupational Therapist
  • Clark, NJ
National Provider Identifier
1174365134
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0008484 Issued in CO
Practice address
4 Brentwood Rd
Clark, NJ 07066-3004
Phone
(732) 535-3274
Fax
(855) 678-8887
NPI assigned
Jun 11, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 0008484 CO Primary

Addresses

Primary practice location

4 Brentwood Rd
Clark, NJ 07066-3004

Mailing address

4 Brentwood Rd
Clark, NJ 07066-3004
Phone (732) 535-3274

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240626004135 CO Practitioner - Occupational Therapist in Private Practice 0143764571 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prestige Rehab ColoradoGroup PAC ID 1759822265, 12 clinicians

Practice addresses (Care Compare)

2020 N Academy Blvd
Suite 261
Colorado Springs, CO 80909-1567
Phone (908) 670-7573

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0008484COMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prestige Rehab Colorado Occupational Therapist CurrentSince Sep 25, 2024 Accepting new patients
Prestige Rehab LLC Occupational Therapist CurrentSince Jun 18, 2024 Accepting new patients

Locations

2020 N Academy Blvd
Ste 261
Colorado Springs, CO 80909
Phone (719) 232-5591

Organizations & group practices 2

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": "1718064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1174365134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 BRENTWOOD RD",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070663004",
            "telephone_number": "732-535-3274",
            "fax_number": "855-678-8887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 BRENTWOOD RD",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070663004",
            "telephone_number": "732-535-3274",
            "fax_number": "855-678-8887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "SUZANNE",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-11",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CO",
            "license": "0008484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; 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.