Individual provider Active NPI

Jessica Kristine Bleske, OTR

  • Occupational Therapist
  • Novi, MI
National Provider Identifier
1386309847
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201012656 Issued in MI
Practice address
44225 W 12 Mile Rd Ste C-106
Novi, MI 48377-2640
Phone
(248) 277-3005
NPI assigned
Nov 1, 2021
Last updated
Aug 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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 5201012656 MI Primary

Addresses

Primary practice location

44225 W 12 Mile Rd Ste C-106
Novi, MI 48377-2640

Mailing address

44225 W 12 Mile Rd Ste C-106
Novi, MI 48377-2640
Phone (248) 277-3005

Other names 1

  • Jessica Kristine Montalbano Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Teams

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211210001870 MI Practitioner - Occupational Therapist in Private Practice 4486044104 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Care Rehabilitation Professionals Occupational Therapist PastSince Oct 23, 2021 Accepting new patients
Peds Speech LLC PastSince Dec 20, 2023 Accepting new patients

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, 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": "1635724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1386309847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44225 W 12 MILE RD STE C-106",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483772640",
            "telephone_number": "248-277-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44225 W 12 MILE RD STE C-106",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483772640",
            "telephone_number": "248-277-3005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLESKE",
        "first_name": "JESSICA",
        "middle_name": "KRISTINE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-01",
        "last_updated": "2022-08-11",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201012656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Teams",
            "affiliation": "N",
            "address_1": "15023 21 Mile Rd",
            "city": "Shelby Twp",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483155024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "MONTALBANO",
            "middle_name": "KRISTINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Novi, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; 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.