Individual provider Active NPI

Maribeth Mazzetta, OT

  • Occupational Therapist
  • Glenview, IL
National Provider Identifier
1306884176
Registry record updated Aug 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
2401 Ravine Way
Suite 100
Glenview, IL 60025-7645
Phone
(847) 724-4791
NPI assigned
Jun 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2007

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 IL Primary

Addresses

Primary practice location

2401 Ravine Way
Suite 100
Glenview, IL 60025-7645

Mailing address

8930 Waukegan Rd
Suite 200 - Attn: Raquel Leon
Morton Grove, IL 60053-2126
Phone (847) 324-3976

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060110000118 IL Practitioner - Occupational Therapist in Private Practice 7315960960 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Illinois Bone and Joint Institute, LLCGroup PAC ID 6002814878, 603 clinicians

Practice addresses (Care Compare)

2101 Waukegan Rd
Bannockburn, IL 60015-1836

2401 Ravine Way
Glenview, IL 60025-7645

Merit-based Incentive Payment System (MIPS)

Final score
81.07 of 100Reported as group
Quality
76.54
Promoting interoperability
83
Improvement activities
40
Cost
74.52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056-001508ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Bone and Joint Institute, LLC CurrentSince Jan 1, 2007 Accepting new patients
Illinois Bone and Joint Institute LLC CurrentSince Jan 1, 2007 Accepting new patients
Illinois Bone and Joint Institute Past Accepting new patients

Locations

2101 Waukegan Rd
Ste 110
Bannockburn, IL 60015
Phone (847) 914-9096

5057 Paysphere Cir
Chicago, IL 60674

900 Rand Rd
Ste 300
Des Plaines, IL 60016
Phone (847) 324-3090

2401 Ravine Way
Ste 100
Glenview, IL 60025
Phone (847) 724-4791

716 Florsheim Dr
Libertyville, IL 60048
Phone (847) 918-9077

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/Freedom_IBJI
  • FHIR API: https://epicproxy.et1195.epichosted.com/fhirproxy/api/FHIR/R4/

Organizations & group practices 3

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": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188259200000",
    "number": "1306884176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8930 WAUKEGAN RD",
            "address_2": "SUITE 200 - ATTN: RAQUEL LEON",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600532126",
            "telephone_number": "847-324-3976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 RAVINE WAY",
            "address_2": "SUITE 100",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600257645",
            "telephone_number": "847-724-4791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZETTA",
        "first_name": "MARIBETH",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2007-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2007; 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.