Individual provider Active NPI

Ann Terese Marotta, COTA

  • Occupational Therapy Assistant
  • Lake in the Hills, IL
National Provider Identifier
1750976338
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
057.005412 Issued in IL
Practice address
525 Harvest Gate
Lake in the Hills, IL 60156-4877
Phone
(847) 957-7070
NPI assigned
Mar 4, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 057.005412 IL Primary

Addresses

Primary practice location

525 Harvest Gate
Lake in the Hills, IL 60156-4877

Mailing address

616 Majic Way
Marengo, IL 60152-3388
Phone (815) 382-5957

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
057.005412ILMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Paxxon Healthcare Services LLC PastSince Mar 7, 2021 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: childtherapyandrehab.annmarotta@158752.advancedmd-direct.com

Organizations & group practices 1

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": "1614816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1750976338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 MAJIC WAY",
            "city": "MARENGO",
            "state": "IL",
            "postal_code": "601523388",
            "telephone_number": "815-382-5957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 HARVEST GATE",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601564877",
            "telephone_number": "847-957-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAROTTA",
        "first_name": "ANN",
        "middle_name": "TERESE",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-04",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057.005412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake in the Hills, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; 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.