Individual provider Active NPI

Jillmary Chazhicattu, MSOTR/L

  • Occupational Therapist
  • Sebring, FL
National Provider Identifier
1225320948
Registry record updated Jan 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
5959 Sun N Lake Blvd
Sebring, FL 33872-2075
Phone
(863) 385-5454
NPI assigned
May 13, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OC011667 PA
Occupational Therapist 225X00000X Primary

Addresses

Primary practice location

5959 Sun N Lake Blvd
Sebring, FL 33872-2075

Mailing address

10810 Gifford St FL 1
Philadelphia, PA 19116-3310

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220224003170 FL Practitioner - Occupational Therapist in Private Practice 3476947003 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5959 Sun N Lake Blvd
Vertis Therapy|Fellowhip Seabring
Seabring, FL 33872-2075
Phone (863) 385-5454

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OC011667PAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Health Care Management LLC Occupational Therapist CurrentSince Feb 1, 2022 Accepting new patients
Creative Health Care Management, LLC Occupational Therapist CurrentSince Feb 1, 2022 Accepting new patients

Locations

5762 SW 60th Ave
Ocala, FL 34474
Phone (352) 237-4544

765 W Grant St
Plant City, FL 33563
Phone (813) 743-3701

10 S 9th St
Ste 4
Noblesville, IN 46060

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": "1305244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673827200000",
    "number": "1225320948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10810 GIFFORD ST FL 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191163310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5959 SUN N LAKE BLVD",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338722075",
            "telephone_number": "863-385-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAZHICATTU",
        "first_name": "JILLMARY",
        "credential": "MSOTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-13",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC011667",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebring, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2023; 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.