Active NPI
Professional Occupational & Physical Therapy, PLLC
- Occupational Therapist
- Fort Lee, NJ
National Provider Identifier
1275013575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- Legal business name
- PROFESSIONAL OCCUPATIONAL & PHYSICAL THERAPY, PLLC
- Practice address
- 2200 Fletcher Ave Ste 505
Fort Lee, NJ 07024-5016 - Phone
- (201) 849-5201
- Fax
- (201) 849-5014
- NPI assigned
- Aug 16, 2018
- Last updated
- Aug 16, 2018
- Organization subpart
- Yes
- Parent organization
- PROFESSIONAL OCCUPATIONAL & PHYSICAL THERAPY, PLLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kathleen Brush
- Title
- Credentialing Manager
- Phone
- (631) 359-5805
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | Primary |
Addresses
Primary practice location
2200 Fletcher Ave Ste 505
Fort Lee, NJ 07024-5016
Mailing address
576 Broadhollow Rd
Melville, NY 11747-5002
Phone (631) 359-5859
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170118000654 | NJ | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 3779873401 |
Receives reassigned benefits from 296 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider Directory- Part of
- Prof Occupational Phyl THP
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534377600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1534377600000",
"number": "1275013575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "576 BROADHOLLOW RD",
"city": "MELVILLE",
"state": "NY",
"postal_code": "117475002",
"telephone_number": "631-359-5859"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 FLETCHER AVE STE 505",
"city": "FORT LEE",
"state": "NJ",
"postal_code": "070245016",
"telephone_number": "201-849-5201",
"fax_number": "201-849-5014"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PROFESSIONAL OCCUPATIONAL & PHYSICAL THERAPY, PLLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PROFESSIONAL OCCUPATIONAL & PHYSICAL THERAPY, PLLC",
"enumeration_date": "2018-08-16",
"last_updated": "2018-08-16",
"status": "A",
"authorized_official_last_name": "BRUSH",
"authorized_official_first_name": "KATHLEEN",
"authorized_official_title_or_position": "CREDENTIALING MANAGER",
"authorized_official_telephone_number": "631-359-5805"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Lee, NJ
- Premier Home Health Care Services
- Premier Home Health Care Services, Inc.
- Premier Professional Temps (Premier Home Health Care)
- Premier Spine and Sports Medicine, P.C.
- Professional Care Home Care Agency, Inc.
- Professional Occupational & Physical Therapy, PLLC
- Professional Oral Surgery Alliance of New Jersey, LLC
- Professional Orthopedic and Sports Therapy of NJ, LLC
- Prompt Med Urgent Care PC (Prompt Med Urgent Care)
- Protect Medical Transportation Services
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.