Individual provider Active NPI

Brian McDonald

  • Pediatric Occupational Therapist
  • Bridgewater, NJ
National Provider Identifier
1245656933
Registry record updated Mar 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
46TR00013700 Issued in NJ
Practice address
377 Union Ave
Bridgewater, NJ 08807-3108
Phone
(908) 725-2366
Fax
(908) 725-3945
NPI assigned
Mar 5, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 46TR00013700 NJ Primary

Addresses

Primary practice location

377 Union Ave
Bridgewater, NJ 08807-3108

Mailing address

377 Union Ave
Bridgewater, NJ 08807-3108
Phone (908) 725-2366

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

State licenses

LicenseStateTypeSpecialty
46TR00013700NJMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Somerset Childrens Center Past Accepting new patients

Organizations & group practices 1

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": "1393977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393977600000",
    "number": "1245656933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "377 UNION AVE",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088073108",
            "telephone_number": "908-725-2366",
            "fax_number": "908-725-3945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 UNION AVE",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088073108",
            "telephone_number": "908-725-2366",
            "fax_number": "908-725-3945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "BRIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-05",
        "last_updated": "2014-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NJ",
            "license": "46TR00013700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgewater, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2014; 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.