Individual provider Active NPI

Jordan Benvenuto, COTA/L

  • Occupational Therapy Assistant
  • Parsippany, NJ
National Provider Identifier
1386430965
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
46TA09190100 Issued in NJ
Practice address
299 Cherry Hill Rd Ste 108
Parsippany, NJ 07054-1124
Phone
(833) 587-1784
NPI assigned
Apr 18, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 46TA09190100 NJ Primary

Addresses

Primary practice location

299 Cherry Hill Rd Ste 108
Parsippany, NJ 07054-1124

Mailing address

299 Cherry Hill Rd Ste 108
Parsippany, NJ 07054-1124
Phone (862) 432-1262

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
46TA09190100NJMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Positive Development Medical of New Jersey PC CurrentSince Apr 20, 2025 Accepting new patients
Positive Development CurrentSince Apr 20, 2025 Accepting new patients

Locations

299 Cherry Hill Rd
Ste 108
Parsippany, NJ 07054
Phone (862) 339-4379

Organizations & group practices 2

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": "1744934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1386430965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "299 CHERRY HILL RD STE 108",
            "city": "PARSIPPANY",
            "state": "NJ",
            "postal_code": "070541124",
            "telephone_number": "862-432-1262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "299 CHERRY HILL RD STE 108",
            "city": "PARSIPPANY",
            "state": "NJ",
            "postal_code": "070541124",
            "telephone_number": "833-587-1784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENVENUTO",
        "first_name": "JORDAN",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-18",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NJ",
            "license": "46TA09190100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parsippany, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2025; 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.