Individual provider Active NPI

Jessica Ariel Rosengold, OT

  • Occupational Therapist
  • Brandon, FL
National Provider Identifier
1346746492
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT19028 Issued in FL
Practice address
560 S Lakewood Dr
Brandon, FL 33511-5015
Phone
(813) 978-9700
NPI assigned
Apr 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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 OT19028 FL Primary

Addresses

Primary practice location

560 S Lakewood Dr
Brandon, FL 33511-5015

Mailing address

13020 N Telecom Pkwy
Temple Terrace, FL 33637-0925
Phone (813) 978-9700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180817000911 FL Practitioner - Occupational Therapist in Private Practice 5597014969 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tallahassee Orthopedic Clinic III, P.L. CurrentSince Sep 17, 2024 Accepting new patients
Musculoskeletal Institute Chartered CurrentSince Mar 9, 2021 Accepting new patients
Tallahassee Orthopedic Clinic III PL CurrentSince Sep 17, 2024 Accepting new patients

Locations

560 S Lakewood Dr
Brandon, FL 33511
Phone (813) 657-8448

560 S Lakewood Dr
Ste 101
Brandon, FL 33511
Phone (813) 657-8448

2011 Harrison Ave
Panama City, FL 32405
Phone (850) 691-4188

803 W Main St
Perry, FL 32347
Phone (850) 584-7078

3334 Capital Medical Blvd
Tallahassee, FL 32308
Phone (850) 210-1808

13060 N Telecom Pkwy
Fl Orthopaedic
Temple Terrace, FL 33637

13020 N Telecom Pkwy
Fl Orthopaedic
Temple Terrace, FL 33637

13020 N Telecom Pkwy
Temple Terrace, FL 33637

2044 Trinity Oaks Blvd
Ste 110
Trinity, FL 34655
Phone (813) 978-7000

Organizations & group practices 4

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": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1346746492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13020 N TELECOM PKWY",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370925",
            "telephone_number": "813-978-9700",
            "fax_number": "813-558-6185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 S LAKEWOOD DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115015",
            "telephone_number": "813-978-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENGOLD",
        "first_name": "JESSICA",
        "middle_name": "ARIEL",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-05",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT19028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; 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.

Verify at the official NPI Registry.