Individual provider Active NPI

Lynn Simon, OTR, CHT

  • Hand Occupational Therapist
  • Montclair, NJ
National Provider Identifier
1396763488
Registry record updated Oct 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
46TR00459400 Issued in NJ
Practice address
1 Greenwood Ave
Suite 100
Montclair, NJ 07042-3617
Phone
(973) 746-2424
Fax
(973) 746-5030
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X 46TR00459400 NJ Primary

Addresses

Primary practice location

1 Greenwood Ave
Suite 100
Montclair, NJ 07042-3617

Mailing address

1 Greenwood Ave
Suite 100
Montclair, NJ 07042-3617
Phone (973) 746-2424

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040308000776 NJ Practitioner - Occupational Therapist in Private Practice 8921996315 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jag-One Physical Therapy LLCGroup PAC ID 2769584325, 334 clinicians

Practice addresses (Care Compare)

622 Eagle Rock Ave
West Orange, NJ 07052-2994
Phone (973) 669-0078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
46TR00459400NJMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jag-One Physical Therapy, LLC CurrentSince Jul 16, 2018 Accepting new patients

Locations

981 US Highway 22
Fl 2
Bridgewater, NJ 08807
Phone (908) 231-0511

221 Rockingham Row
Princeton, NJ 08540
Phone (609) 580-1520

622 Eagle Rock Ave
West Orange, NJ 07052
Phone (973) 669-0078

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477872000000",
    "number": "1396763488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GREENWOOD AVE",
            "address_2": "SUITE 100",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070423617",
            "telephone_number": "973-746-2424",
            "fax_number": "973-746-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GREENWOOD AVE",
            "address_2": "SUITE 100",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070423617",
            "telephone_number": "973-746-2424",
            "fax_number": "973-746-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "OTR, CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2016-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "NJ",
            "license": "46TR00459400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2016; 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.