Individual provider Active NPI

Tamara Jefferson, OTR/L

  • Occupational Therapist
  • Orlando, FL
National Provider Identifier
1720620537
Registry record updated Oct 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT10353 Issued in FL
Practice address
5164 Clarion Oaks Drive
Orlando, FL 32808
Phone
(904) 501-6633
NPI assigned
Oct 14, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT10353 FL Primary

Addresses

Primary practice location

5164 Clarion Oaks Drive
Orlando, FL 32808

Mailing address

5164 Clarion Oaks Drive
Orlando, FL 32808
Phone (904) 501-6633

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200219002451 FL Practitioner - Occupational Therapist in Private Practice 6002243771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sobe Innovative Rehabilitation PLLCGroup PAC ID 4789994336, 178 clinicians

Practice addresses (Care Compare)

279 NW California Blvd
Port Saint Lucie, FL 34986-2507
Phone (786) 770-9480

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT10353FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sobe Innovative Rehabilitation PLLC Occupational Therapist CurrentSince Aug 23, 2023 Accepting new patients
Emergent Home and Health LLC CurrentSince Nov 17, 2019 Accepting new patients
Strength and Balance Institute Occupational Therapist PastSince Aug 11, 2019 Accepting new patients

Locations

2777 NE 183rd St
Aventura, FL 33160
Phone (305) 405-2014

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": "1571011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571011200000",
    "number": "1720620537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5164 CLARION OAKS DRIVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32808",
            "telephone_number": "904-501-6633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5164 CLARION OAKS DRIVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32808",
            "telephone_number": "904-501-6633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "TAMARA",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-14",
        "last_updated": "2019-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT10353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.