Individual provider Active NPI

Mary Broshkevitch

  • Occupational Therapist
  • Cherry Hill, NJ
National Provider Identifier
1629472147
Registry record updated Jan 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
07578 Issued in MD
Practice address
7 Carnegie PLZ
Cherry Hill, NJ 08003-1000
Phone
(877) 407-3422
Fax
(877) 407-4329
NPI assigned
Oct 13, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2019

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 07578 MD Primary
Occupational Therapist 225X00000X OC013378 PA

Addresses

Primary practice location

7 Carnegie PLZ
Cherry Hill, NJ 08003-1000

Mailing address

7 Carnegie PLZ
Cherry Hill, NJ 08003-1000
Phone (877) 407-3422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD, PA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20150115001528 DC Practitioner - Occupational Therapist in Private Practice 1658695903 Reassigns benefits to 1 organization
I20150313001349 MD Practitioner - Occupational Therapist in Private Practice 1658695903 Reassigns benefits to 1 organization
I20170921001029 PA Practitioner - Occupational Therapist in Private Practice 1658695903 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehab OT MD LLCGroup PAC ID 4981847977, 60 clinicians

Practice addresses (Care Compare)

6451 N Charles St
Baltimore, MD 21212-1010
Phone (877) 407-3422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
07578MDMDSocial Worker
OC013378PAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehab OT MD LLC Occupational Therapist CurrentSince Nov 25, 2014 Accepting new patients
Fox Rehabilitation Services Inc Occupational Therapist CurrentSince Jul 17, 2017 Accepting new patients
Fox Rehabilitation Services LLC Occupational Therapist CurrentSince Nov 6, 2014 Accepting new patients

Locations

45 Saint Patricks Dr
Waldorf, MD 20603
Phone (301) 868-7121

11665 Doolittle Dr
Waldorf, MD 20602
Phone (301) 638-4100

7 Carnegie Plz
Cherry Hill, NJ 08003

470 N Lewis Rd
Limerick, PA 19468
Phone (610) 792-8800

10475 Perry Hwy
Ste 106G
Wexford, PA 15090
Phone (877) 407-4322

1122 Highway 315 Blvd
Wilkes Barre, PA 18702
Phone (877) 407-4322

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": "1413158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548460800000",
    "number": "1629472147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CARNEGIE PLZ",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080031000",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 CARNEGIE PLZ",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080031000",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROSHKEVITCH",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-13",
        "last_updated": "2019-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "07578",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC013378",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2019; 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.