Individual provider Active NPI

Michael Tolerico, OTR/L

  • Hand Occupational Therapist
  • Montclair, NJ
National Provider Identifier
1780228254
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
46TR00898000 Issued in NJ
Practice address
1 Greenwood Ave
Montclair, NJ 07042-3649
Phone
(973) 746-2424
NPI assigned
Oct 29, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X 46TR00898000 NJ Primary

Addresses

Primary practice location

1 Greenwood Ave
Montclair, NJ 07042-3649

Mailing address

576 Broadhollow Rd
Melville, NY 11747-5002

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191121001802 NJ Practitioner - Occupational Therapist in Private Practice 5698107159 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Occupational and Physical Therapy, PLLCGroup PAC ID 3779873401, 497 clinicians

Practice addresses (Care Compare)

524 Williamstown Rd
Sicklerville, NJ 08081-1800
Phone (856) 516-0593

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile Therapy Services, Inc. CurrentSince Oct 25, 2019 Accepting new patients
Professional Occupational & Physical Therapy, PLLC CurrentSince Nov 4, 2019 Accepting new patients
Professional Occupational & Physical Therapy, PLLC CurrentSince Nov 4, 2019 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Current Accepting new patients
Ignite Rehab Corp CurrentSince Sep 1, 2022 Accepting new patients

Locations

1003 Main Ave
Clifton, NJ 07011
Phone (201) 344-2499

187 Millburn Ave
Ste 110
Millburn, NJ 07041
Phone (973) 467-7976

1 Greenwood Ave
Montclair, NJ 07042
Phone (973) 746-2424

524 Williamstown Rd
Ste B1
Sicklerville, NJ 08081
Phone (856) 516-0591

524 Williamstown Rd
Sicklerville, NJ 08081
Phone (856) 262-9564

576 Broadhollow Rd
Melville, NY 11747

8 John Walsh Blvd
Ste 406A
Peekskill, NY 10566
Phone (732) 440-7858

Organizations & group practices 5

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": "1572307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1780228254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GREENWOOD AVE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070423649",
            "telephone_number": "973-746-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLERICO",
        "first_name": "MICHAEL",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-29",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "NJ",
            "license": "46TR00898000",
            "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 Oct 29, 2019; 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.