Burt Michael Lacivita, M.S. OTR

Primary specialty

Hand Occupational TherapistTaxonomy code 225XH1200X

License

46TR00395600 Issued in NJ

Practice address

81 Northfield Ave
Suite 104
West Orange, NJ 07052-5342

Phone

(973) 325-0229

Fax

(973) 325-1105

NPI assigned

Feb 19, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

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.

• Century Adult Day Health Services, LLC

  • Adult Day Care Clinic/Center
  • West Orange, NJ
  • NPI 1588081327
  NPD (past) Authorized official
• Zma Rehabilitation Services LLC

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • West Orange, NJ
  • NPI 1083911507
  NPD (past) Authorized official

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253750400000",
    "number": "1659549095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 S CENTRE ST",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070792609",
            "telephone_number": "201-923-7533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 NORTHFIELD AVE",
            "address_2": "SUITE 104",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070525342",
            "telephone_number": "973-325-0229",
            "fax_number": "973-325-1105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACIVITA",
        "first_name": "BURT",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "M.S. OTR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-19",
        "last_updated": "2009-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "NJ",
            "license": "46TR00395600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jolly M Kuruvilla
• Alyssa Hope Kutyla
• Steven C Labarbera, M.S. CCC-SLP
• Kelli Labashosky, DO
• Stacey Lisa Lachs, PA-C
• Gina Lackey Diggs, B.S., CNC
• Lewis Thomas Ladocsi, MD
• Bernadette Cinthia Lafond, MA, CCC, SLP
• Victoria Sunil Lal, M.D.
• Sanjay Lalla, M. D.

• Hand Occupational Therapist in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Hand Occupational Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.