Individual provider Active NPI

Anzhelika Ihnatenko, OTR/L

  • Occupational Therapist
  • Eatontown, NJ
National Provider Identifier
1235840018
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
46TR01099900 Issued in NJ
Practice address
1 Main St Ste 505
Eatontown, NJ 07724-3903
Phone
(732) 493-3100
NPI assigned
Dec 12, 2022
Last updated
Dec 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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 46TR01099900 NJ Primary

Addresses

Primary practice location

1 Main St Ste 505
Eatontown, NJ 07724-3903

Mailing address

1 Main St Ste 505
Eatontown, NJ 07724-3903
Phone (347) 500-0281

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221229002142 NJ Practitioner - Occupational Therapist in Private Practice 2567832983 Reassigns benefits to 1 organization
I20230627002333 NY Practitioner - Occupational Therapist in Private Practice 2567832983 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

16 Sumner PL
Brooklyn, NY 11206-4110
Phone 71895188002102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
46TR01099900NJMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ahava Medical and Rehabilitation Center, LLC CurrentSince Dec 1, 2023 Accepting new patients
Mobile Therapy Services, Inc. Occupational Therapist CurrentSince Dec 15, 2022 Accepting new patients
Anchor Health Homecare Services Inc Occupational Therapist CurrentSince May 20, 2023 Accepting new patients
Prime Rehabilitation Services, Inc. Occupational Therapist PastSince Jan 31, 2021 Accepting new patients

Locations

1 Main St
Ste 505
Tinton Falls, NJ 07724

16 Sumner Pl
Brooklyn, NY 11206
Phone (718) 336-9500

2555 Nostrand Ave
Brooklyn, NY 11210
Phone 7189518800108

46 Cook St
Brooklyn, NY 11206
Phone (718) 701-7300

958 Nostrand Ave
Brooklyn, NY 11225
Phone (347) 423-9031

8 John Walsh Blvd
Ste 406A
Peekskill, NY 10566
Phone (732) 440-7858

Organizations & group practices 4

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": "1670803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1235840018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MAIN ST STE 505",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077243903",
            "telephone_number": "347-500-0281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MAIN ST STE 505",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077243903",
            "telephone_number": "732-493-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IHNATENKO",
        "first_name": "ANZHELIKA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-12",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR01099900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eatontown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.