Individual provider Active NPI

Marissa Bennici, OTR/L

  • Occupational Therapist
  • Lakewood, NJ
National Provider Identifier
1730894304
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
436 Chestnut St
Lakewood, NJ 08701-5811
Phone
(866) 959-2846
NPI assigned
Jan 18, 2023
Last updated
Jan 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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 DE Primary

Addresses

Primary practice location

436 Chestnut St
Lakewood, NJ 08701-5811

Mailing address

436 Chestnut St
Lakewood, NJ 08701-5811

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230131003028 DE Practitioner - Occupational Therapist in Private Practice 9133590052 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
At Home by Enhance Therapies LLC Occupational Therapist CurrentSince Dec 1, 2022 Accepting new patients
Tender Touch at Home NJ LLC PastSince Jan 22, 2023 Accepting new patients

Locations

200 Continental Dr
Ste 401
Newark, DE 19713
Phone (302) 238-6200

400 Route 70
Lakewood, NJ 08701
Phone (609) 805-1686

685 River Ave
Unit 1
Lakewood, NJ 08701

Organizations & group practices 2

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": "1674000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1730894304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 CHESTNUT ST",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 CHESTNUT ST",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015811",
            "telephone_number": "866-959-2846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNICI",
        "first_name": "MARISSA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-18",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "DE",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.