Individual provider Active NPI

Amanda Brogno

  • Occupational Therapist
  • Phila, PA
National Provider Identifier
1730295288
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
6595 B E Roosevelt Blvd
Phila, PA 19149
Phone
(215) 743-2332
NPI assigned
Aug 21, 2006
Last updated
Jan 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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 OC010804 PA
Occupational Therapist 225X00000X Primary

Addresses

Primary practice location

6595 B E Roosevelt Blvd
Phila, PA 19149

Mailing address

6595 B E Roosevelt Blvd
Phila, PA 19149
Phone (215) 743-2332

Other identifiers 1

IdentifierTypeStateIssuer
2877OtherAZLICENSE #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140507002003 PA Practitioner - Occupational Therapist in Private Practice 6305079872 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabclinics (SPT), Inc. Current Accepting new patients
Novacare Outpatient Rehabilitation East, Inc. Current Accepting new patients
Novacare Outpatient Rehabilitation East, Inc. CurrentSince Aug 10, 2021 Accepting new patients
Rehabclinics SPT, Inc. CurrentSince Apr 1, 2018 Accepting new patients
Rehabclinics SPT, Inc. CurrentSince Apr 1, 2018 Accepting new patients

Locations

4275 County Line Rd
Ste 26
Chalfont, PA 18914
Phone (267) 952-8120

604 Commons Dr
Ste D3
Oxford, PA 19363
Phone (610) 932-3619

6595 Roosevelt Blvd
#B
Philadelphia, PA 19149
Phone (215) 743-2332

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1730295288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6595 B E ROOSEVELT BLVD",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "19149",
            "telephone_number": "215-743-2332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6595 B E ROOSEVELT BLVD",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "19149",
            "telephone_number": "215-743-2332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROGNO",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC010804",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "2877",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phila, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; 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.