Individual provider Active NPI

Marissa Ann Berglund, OTR/L

  • Occupational Therapist
  • Plantsville, CT
National Provider Identifier
1467969626
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
4923 Issued in CT
Practice address
1261 S Main St
Plantsville, CT 06479-1750
Phone
(860) 628-9000
NPI assigned
Jan 9, 2018
Last updated
Apr 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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 4923 CT Primary

Addresses

Primary practice location

1261 S Main St
Plantsville, CT 06479-1750

Mailing address

29 Steele Ave
Wolcott, CT 06716-3223
Phone (203) 695-2178

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250416000523 CT Practitioner - Occupational Therapist in Private Practice 8022533793 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Group practices
Align Motion LLCGroup PAC ID 0143554592, 7 clinicians

Practice addresses (Care Compare)

491 N Main St
Naugatuck, CT 06770-3032
Phone (203) 518-6065

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4923CTMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Align Motion LLC CurrentSince Apr 9, 2025 Accepting new patients

Locations

491 N Main St
Naugatuck, CT 06770
Phone (203) 518-6065

92 Brookside Rd
Ste 112
Waterbury, CT 06708

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, 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": "1515456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1467969626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 STEELE AVE",
            "city": "WOLCOTT",
            "state": "CT",
            "postal_code": "067163223",
            "telephone_number": "203-695-2178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1261 S MAIN ST",
            "city": "PLANTSVILLE",
            "state": "CT",
            "postal_code": "064791750",
            "telephone_number": "860-628-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGLUND",
        "first_name": "MARISSA",
        "middle_name": "ANN",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-09",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CT",
            "license": "4923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantsville, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; 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.