Individual provider Active NPI

Casey Ellis

  • Occupational Therapist
  • Wexford, PA
National Provider Identifier
1760169593
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OC018316 Issued in PA
Practice address
10475 Perry Hwy Ste 106G
Wexford, PA 15090-9213
Phone
(877) 407-3422
Fax
(877) 407-4329
NPI assigned
Jul 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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 OC018316 PA Primary

Addresses

Primary practice location

10475 Perry Hwy Ste 106G
Wexford, PA 15090-9213

Mailing address

7 Carnegie PLZ
Cherry Hill, NJ 08003-1000
Phone (877) 407-3422

Other names 1

  • Casey Burke Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230719000021 PA Practitioner - Occupational Therapist in Private Practice 8325408644 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehabilitation Services IncGroup PAC ID 0143133009, 1,169 clinicians

Practice addresses (Care Compare)

1122 Hwy 315 Blvd
Wilkes Barre, PA 18702-6943
Phone (877) 407-3422

470 N Lewis Rd
Bon Homie LTD Adult Day Center
Limerick, PA 19468-1511
Phone (610) 792-8800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Services Inc Occupational Therapist CurrentSince Jul 1, 2023 Accepting new patients

Locations

7 Carnegie Plz
Cherry Hill, NJ 08003

470 N Lewis Rd
Limerick, PA 19468
Phone (610) 792-8800

10475 Perry Hwy
Ste 106G
Wexford, PA 15090
Phone (877) 407-4322

1122 Highway 315 Blvd
Wilkes Barre, PA 18702
Phone (877) 407-4322

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": "1688342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1760169593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CARNEGIE PLZ",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080031000",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10475 PERRY HWY STE 106G",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150909213",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "CASEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-03",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC018316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASEY",
            "last_name": "BURKE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wexford, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; 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.