Individual provider Active NPI

Kibwe Calzado, MS, OTR/L

  • Occupational Therapist
  • Hazlet, NJ
National Provider Identifier
1215790613
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
46TR01113400 Issued in NJ
Practice address
82 Bethany Rd Ste 1
Hazlet, NJ 07730-1459
Phone
(732) 888-3912
Fax
(732) 888-2916
NPI assigned
Jan 30, 2024
Last updated
Jan 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 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 46TR01113400 NJ Primary

Addresses

Primary practice location

82 Bethany Rd Ste 1
Hazlet, NJ 07730-1459

Mailing address

191 N Broadway Apt B
South Amboy, NJ 08879-1603
Phone (609) 789-6961

Other practice location 1

21 Cedar Ave Ste B-1
Fair Haven, NJ 07704-3264
Phone (732) 888-3912

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
46TR01113400NJMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Speech Start, LLC PastSince Apr 6, 2023 Accepting new patients
Speech Start, LLC PastSince Apr 6, 2023 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1706572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1215790613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 N BROADWAY APT B",
            "city": "SOUTH AMBOY",
            "state": "NJ",
            "postal_code": "088791603",
            "telephone_number": "609-789-6961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 BETHANY RD STE 1",
            "city": "HAZLET",
            "state": "NJ",
            "postal_code": "077301459",
            "telephone_number": "732-888-3912",
            "fax_number": "732-888-2916"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 Cedar Ave Ste B-1",
            "address_purpose": "LOCATION",
            "city": "Fair Haven",
            "state": "NJ",
            "postal_code": "077043264",
            "country_code": "US",
            "telephone_number": "732-888-3912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALZADO",
        "first_name": "KIBWE",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-30",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR01113400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazlet, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.