Individual provider Active NPI

Samantha Cecilia Krych, OTD

  • Occupational Therapist
  • Montclair, NJ
National Provider Identifier
1770237281
Registry record updated Nov 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
46TR01031600 Issued in NJ
Practice address
17 Watchung PLZ
Montclair, NJ 07042-4117
Phone
(973) 744-0804
NPI assigned
Feb 4, 2022
Last updated
Nov 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 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 46TR01031600 NJ Primary

Addresses

Primary practice location

17 Watchung PLZ
Montclair, NJ 07042-4117

Mailing address

70 Beverly Rd
West Caldwell, NJ 07006-6531
Phone (973) 865-4424

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220627000466 NJ Practitioner - Occupational Therapist in Private Practice 9830578566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lori Speaks, LLCGroup PAC ID 0446569644, 16 clinicians

Practice addresses (Care Compare)

17 Watchung PLZ
Montclair, NJ 07042-4117
Phone (973) 744-0804

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lori Speaks, LLC CurrentSince Jun 1, 2022 Accepting new patients

Locations

17 Watchung Plz
Montclair, NJ 07042
Phone (973) 744-0804

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, 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": "1643932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700352000000",
    "number": "1770237281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 BEVERLY RD",
            "city": "WEST CALDWELL",
            "state": "NJ",
            "postal_code": "070066531",
            "telephone_number": "973-865-4424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 WATCHUNG PLZ",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070424117",
            "telephone_number": "973-744-0804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRYCH",
        "first_name": "SAMANTHA",
        "middle_name": "CECILIA",
        "credential": "OTD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-04",
        "last_updated": "2023-11-19",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR01031600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.