Individual provider Active NPI

Alyssa Detommaso, OT

  • Physical Rehabilitation Occupational Therapist
  • Hoboken, NJ
National Provider Identifier
1295325850
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X
License
46TR00807400 Issued in NJ
Practice address
1330 Willow Ave Apt 606
Hoboken, NJ 07030-3370
Phone
(201) 956-0784
NPI assigned
Jan 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Rehabilitation Occupational Therapist 225XP0019X 46TR00807400 NJ Primary

Addresses

Primary practice location

1330 Willow Ave Apt 606
Hoboken, NJ 07030-3370

Mailing address

718 Teaneck Rd
Teaneck, NJ 07666-4245
Phone (201) 833-3085

Other practice location 1

718 Teaneck Rd
Teaneck, NJ 07666-4245
Phone (201) 833-3085

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL teaneck Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
77.35 of 100Reported as group
Quality
73.31
Improvement activities
40
Cost
73.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
023103NYMDMassage Therapist
46TR00807400NJMDPhysical Rehabilitation Occupational Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1611014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1295325850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 TEANECK RD",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664245",
            "telephone_number": "201-833-3085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 WILLOW AVE APT 606",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070303370",
            "telephone_number": "201-956-0784"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "718 Teaneck Rd",
            "address_purpose": "LOCATION",
            "city": "Teaneck",
            "state": "NJ",
            "postal_code": "076664245",
            "country_code": "US",
            "telephone_number": "201-833-3085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DETOMMASO",
        "first_name": "ALYSSA",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-19",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "NJ",
            "license": "46TR00807400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "teaneck",
            "affiliation": "N",
            "endpointDescription": "Holy Name Medical Center",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "718 Teaneck Rd",
            "city": "Teaneck",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "076664245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hoboken, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.