Individual provider Active NPI

Marisa Hoffman, OT

  • Occupational Therapist
  • Needham, MA
National Provider Identifier
1770047219
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTL14796 Issued in MA
Practice address
589 Highland Ave
Needham, MA 02494-2205
Phone
(781) 455-9090
Fax
(855) 232-8604
NPI assigned
Jan 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 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 OTL14796 MA Primary

Addresses

Primary practice location

589 Highland Ave
Needham, MA 02494-2205

Mailing address

160 Main St
Walpole, MA 02081-4037
Phone (508) 660-3080

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230705002546 MA Practitioner - Occupational Therapist in Private Practice 1052770377 Reassigns benefits to 2 organizations

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

Practice addresses (Care Compare)

362 Belmont St
Brockton, MA 02301-4950
Phone (508) 584-6624

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince May 24, 2023 Accepting new patients
Bay State Physical Therapy of Randolph Inc CurrentSince Jan 1, 2024 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince May 24, 2023 Accepting new patients

Locations

362 Belmont St
Brockton, MA 02301
Phone (508) 584-6622

1343 Providence Hwy
Norwood, MA 02062
Phone (781) 702-1339

26 S Main St
Randolph, MA 02368
Phone (781) 961-9200

Organizations & group practices 4

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": "1548720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1770047219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 MAIN ST",
            "city": "WALPOLE",
            "state": "MA",
            "postal_code": "020814037",
            "telephone_number": "508-660-3080",
            "fax_number": "508-660-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "589 HIGHLAND AVE",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024942205",
            "telephone_number": "781-455-9090",
            "fax_number": "855-232-8604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFFMAN",
        "first_name": "MARISA",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-29",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "OTL14796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Needham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; 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.