Individual provider Active NPI

Jacob Katz

  • Occupational Therapist
  • Vero Beach, FL
National Provider Identifier
1366895187
Registry record updated Jul 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
17090 Issued in FL
Practice address
1155 35TH LN Ste 100
Vero Beach, FL 32960-6522
Phone
(205) 259-3991
NPI assigned
Jul 16, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 17090 FL
Occupational Therapist 225X00000X 17090 FL Primary

Addresses

Primary practice location

1155 35TH LN Ste 100
Vero Beach, FL 32960-6522

Mailing address

1155 35TH LN Ste 100
Vero Beach, FL 32960-6522

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17090FLMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vero Orthopaedics II PA PastSince Jul 1, 2016 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 1

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": "1468627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468627200000",
    "number": "1366895187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 35TH LN STE 100",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329606522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 35TH LN STE 100",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329606522",
            "telephone_number": "205-259-3991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATZ",
        "first_name": "JACOB",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-16",
        "last_updated": "2016-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "17090",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "17090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.