Individual provider Active NPI

Dante Velasquez Henson, OTR/L

  • Occupational Therapist
  • Union, NJ
National Provider Identifier
1619902145
Registry record updated Aug 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
46TR00621200 Issued in NJ
Practice address
1314 Liberty Ave
Union, NJ 07083-4142
Phone
(201) 606-3678
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 014206 NY
Occupational Therapist 225X00000X 46TR00621200 NJ Primary

Addresses

Primary practice location

1314 Liberty Ave
Union, NJ 07083-4142

Mailing address

1314 Liberty Ave
Union, NJ 07083-4142
Phone (201) 606-3678

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130716000518 NJ Practitioner - Occupational Therapist in Private Practice 3971743964 Reassigns benefits to 1 organization

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
Magna Vita Rehab and WellnessGroup PAC ID 2163895970, 2 clinicians

Practice addresses (Care Compare)

397 Haledon Ave
Haledon, NJ 07508-1551
Phone (973) 975-0035

725 Valley Brook Ave
Lyndhurst, NJ 07071-2030
Phone (973) 975-0035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Holsman Physical and Occupational Therapy PC Occupational Therapist CurrentSince Jun 27, 2013 Accepting new patients
Magna Vita Rehab and Wellness CurrentSince Apr 3, 2023 Accepting new patients

Locations

1070 Clifton Ave
Ste 1A
Clifton, NJ 07013
Phone (973) 246-6565

397 Haledon Ave
Haledon, NJ 07508
Phone (973) 427-0023

711 Kearny Ave
#2
Kearny, NJ 07032
Phone (201) 535-8555

725 Valley Brook Ave
Lyndhurst, NJ 07071
Phone (201) 933-0711

1600 Saint Georges Ave
Ste 107
Rahway, NJ 07065
Phone (732) 428-5566

616 Bloomfield Ave
Ste 3A
West Caldwell, NJ 07006
Phone (973) 228-1948

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471305600000",
    "number": "1619902145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 LIBERTY AVE",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070834142",
            "telephone_number": "201-606-3678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 LIBERTY AVE",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070834142",
            "telephone_number": "201-606-3678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSON",
        "first_name": "DANTE",
        "middle_name": "VELASQUEZ",
        "name_prefix": "Mr.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2016-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "014206",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00621200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.