Individual provider Active NPI

Jessica Collins Ekberg

  • Occupational Therapist
  • Woburn, MA
National Provider Identifier
1548416936
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
8331 Issued in MA
Practice address
800 W Cummings Park Ste 1400
Woburn, MA 01801-6374
Phone
(781) 935-7701
NPI assigned
Aug 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 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 8331 MA Primary

Addresses

Primary practice location

800 W Cummings Park Ste 1400
Woburn, MA 01801-6374

Mailing address

800 W Cummings Park Ste 1400
Woburn, MA 01801-6374
Phone (781) 935-7701

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130129000200 MA Practitioner - Occupational Therapist in Private Practice 9436303468 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletic Evolution Physical Therapy LLCGroup PAC ID 2163785221, 5 clinicians

Practice addresses (Care Compare)

800 W Cummings Park
Suite 1550
Woburn, MA 01801-6351
Phone (781) 935-7701

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8331MAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletic Evolution Physical Therapy, LLC CurrentSince Feb 15, 2025 Accepting new patients
Athletic Evolution Strength and Conditioning, Inc CurrentSince Nov 15, 2024 Accepting new patients
Jessica Ekberg OT LLC Occupational Therapist Current Accepting new patients

Locations

60 Concord St
Unit I
Wilmington, MA 01887
Phone (781) 935-7701

800 W Cummings Park
Ste 1550
Woburn, MA 01801
Phone (781) 935-7701

800 W Cummings Park
Ste 1400
Woburn, MA 01801
Phone (781) 281-8078

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1219017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1548416936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 W CUMMINGS PARK STE 1400",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018016374",
            "telephone_number": "781-935-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W CUMMINGS PARK STE 1400",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018016374",
            "telephone_number": "781-935-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS EKBERG",
        "first_name": "JESSICA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-18",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "8331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.