NPIMap

Organization Active NPI

Max Potential Rehab

  • Occupational Therapist
  • Mount Laurel, NJ
National Provider Identifier
1689371544
Registry record updated Feb 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
MAX POTENTIAL REHAB
Practice address
2207A Durham CT
Mount Laurel, NJ 08054-4224
Phone
(201) 744-5122
NPI assigned
Feb 10, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2023

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

Authorized official

Name
Pearl Villanueva, OTRLNPI 1124509039
Title
Co-Owner
Phone
(201) 744-5122

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X Primary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

2207A Durham CT
Mount Laurel, NJ 08054-4224

Mailing address

2207A Durham CT
Mount Laurel, NJ 08054-4224

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230523000049 NJ Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9234595984 Receives reassigned benefits from 17 practitioners
Practice locations: Mount Laurel, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1675987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675987200000",
    "number": "1689371544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2207A DURHAM CT",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080544224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2207A DURHAM CT",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080544224",
            "telephone_number": "201-744-5122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAX POTENTIAL REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-10",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A",
        "authorized_official_last_name": "VILLANUEVA",
        "authorized_official_first_name": "PEARL",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "201-744-5122",
        "authorized_official_credential": "OTRL"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Laurel, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.