Individual provider Active NPI

Emma Rooss

  • Occupational Therapist
  • Somerville, NJ
National Provider Identifier
1295207439
Registry record updated Dec 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
19200 Issued in CA
Practice address
190 N Middaugh St
Somerville, NJ 08876-1404
Phone
(908) 566-7291
NPI assigned
Dec 28, 2018
Last updated
Dec 28, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2018

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 10900329-4201 UT
Occupational Therapist 225X00000X OT.0005550 CO
Occupational Therapist 225X00000X 379938 OR
Occupational Therapist 225X00000X OT3508 ME
Occupational Therapist 225X00000X 46TR00784500 NJ
Occupational Therapist 225X00000X 19200 CA Primary

Addresses

Primary practice location

190 N Middaugh St
Somerville, NJ 08876-1404

Mailing address

190 N Middaugh St
Somerville, NJ 08876-1404
Phone (908) 566-7291

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241004000961 OR Practitioner - Occupational Therapist in Private Practice 8426589169 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

2875 14TH Ave SE
Albany, OR 97322-7078
Phone (541) 967-9700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19200CAMDProfessional Counselor
OT.0005550COMDOccupational Therapist
OT3508MEMDOccupational Therapist
46TR00784500NJMDOccupational Therapist
379938ORMDOccupational Therapist
10900329-4201UTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Select Rehabilitation, LLC Occupational Therapist CurrentSince Aug 19, 2024 Accepting new patients
Cascade Family Care PC Past Accepting new patients

Locations

2875 14th Ave SE
Albany, OR 97322
Phone (541) 967-9700

1010 NE Purcell Blvd
Bend, OR 97701
Phone (541) 318-6042

20225 Powers Rd
Bend, OR 97702
Phone (541) 318-3322

4650 SW Hollyhock Cir
Corvallis, OR 97333
Phone (541) 758-2026

3720 N Clarey St
Eugene, OR 97402
Phone (541) 687-9390

3760 N Clarey St
Eugene, OR 97402
Phone (541) 607-9525

621 W Oak St
Lebanon, OR 97355
Phone (541) 258-7777

4452 Lancaster Dr NE
Salem, OR 97305
Phone (503) 390-3216

5881 Woodside Dr SE
Salem, OR 97306
Phone (503) 316-0687

4851 Main St
Springfield, OR 97478
Phone (541) 747-1887

4865 Main St
Springfield, OR 97478
Phone (541) 284-2865

9000 SW 91st Ave
Tigard, OR 97223
Phone (503) 445-4363

17950 SW 115th Ave
Tualatin, OR 97062
Phone (503) 692-1748

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": "1545955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545955200000",
    "number": "1295207439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 N MIDDAUGH ST",
            "city": "SOMERVILLE",
            "state": "NJ",
            "postal_code": "088761404",
            "telephone_number": "908-566-7291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 N MIDDAUGH ST",
            "city": "SOMERVILLE",
            "state": "NJ",
            "postal_code": "088761404",
            "telephone_number": "908-566-7291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOSS",
        "first_name": "EMMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-28",
        "last_updated": "2018-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "UT",
            "license": "10900329-4201",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CO",
            "license": "OT.0005550",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OR",
            "license": "379938",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ME",
            "license": "OT3508",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00784500",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "19200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2018; 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.