Individual provider Active NPI

Michelle Lori Ruggiero

  • Occupational Therapist
  • Fair Lawn, NJ
National Provider Identifier
1679289060
Registry record updated Jan 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
46TR00469700 Issued in NJ
Practice address
12-10 Floral Ave
Fair Lawn, NJ 07410-2200
Phone
(201) 776-7551
NPI assigned
Jan 27, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X 46TR00469700 NJ Primary
Pediatric Occupational Therapist 225XP0200X 46TR00469700 NJ

Addresses

Primary practice location

12-10 Floral Ave
Fair Lawn, NJ 07410-2200

Mailing address

12-10 Floral Ave
Fair Lawn, NJ 07410-2200
Phone (201) 776-7551

Other identifiers 1

IdentifierTypeStateIssuer
01OtherNJINSURANCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
46TR00469700NJMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1674777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674777600000",
    "number": "1679289060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12-10 FLORAL AVE",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102200",
            "telephone_number": "201-776-7551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12-10 FLORAL AVE",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102200",
            "telephone_number": "201-776-7551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUGGIERO",
        "first_name": "MICHELLE",
        "middle_name": "LORI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-27",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00469700",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NJ",
            "license": "46TR00469700",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSURANCE",
            "identifier": "01",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2023; 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.