Individual provider Active NPI

Monique Renee Bleau, OTR/L

  • Occupational Therapist
  • Beverly, MA
National Provider Identifier
1770992125
Registry record updated Sep 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
13285 Issued in MA
Practice address
100 Cummings Ctr Ste 350G
Beverly, MA 01915-6136
Phone
(978) 712-0003
NPI assigned
Aug 11, 2014
Reactivated
Sep 25, 2019
Last updated
Sep 26, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 13285 MA Primary
Developmental Therapist 222Q00000X NU

Addresses

Primary practice location

100 Cummings Ctr Ste 350G
Beverly, MA 01915-6136

Mailing address

100 Cummings Ctr Ste 350G
Beverly, MA 01915-6136
Phone (978) 712-0003

Other practice location 1

6 Southside Rd
Danvers, MA 01923-1409
Phone (978) 762-8352

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
13285MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peer Projects, LLC PastSince Sep 29, 2019 Accepting new patients

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": "1407715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1770992125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CUMMINGS CTR STE 350G",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156136",
            "telephone_number": "978-712-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CUMMINGS CTR STE 350G",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156136",
            "telephone_number": "978-712-0003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Southside Rd",
            "address_purpose": "LOCATION",
            "city": "Danvers",
            "state": "MA",
            "postal_code": "019231409",
            "country_code": "US",
            "telephone_number": "978-762-8352",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLEAU",
        "first_name": "MONIQUE",
        "middle_name": "RENEE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-11",
        "last_updated": "2019-09-26",
        "deactivation_date": "2019-09-12",
        "reactivation_date": "2019-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "13285",
            "primary": true
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2019; 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.