Professional Occupational & Physical Therapy, PLLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

PROFESSIONAL OCCUPATIONAL & PHYSICAL THERAPY, PLLC

Practice address

84 Orient Way
Rutherford, NJ 07070-2052

Phone

(201) 514-4900

Fax

(201) 340-4141

NPI assigned

Oct 9, 2016

Last updated

Mar 29, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kathleen Brush

Title

Credentialing Manager

Phone

(718) 819-6805

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kimberly Afordakos, DPT

  • Physical Therapist
  • Lyndhurst, NJ
  • NPI 1043224215
  NPD
• Jaclyn Baldini

  • Physical Therapist
  • Summit, NJ
  • NPI 1871911719
  NPD
• Alexander Ivashenko, PT DPT

  • Orthopedic Physical Therapist
  • Edison, NJ
  • NPI 1134289796
  NPD
• Kamon Jaksarn

  • Orthopedic Physical Therapist
  • Mahwah, NJ
  • NPI 1437632015
  NPD
• Thomas J Kaynak, PT

  • Physical Therapist
  • Saddle Brook, NJ
  • NPI 1124127212
  NPD
• Jennifer Nicole Leseur, PT, DPT

  • Physical Therapist
  • Flanders, NJ
  • NPI 1679941348
  NPD
• Nicholas Michael Licameli, PT, DPT

  • Physical Therapist
  • Clifton, NJ
  • NPI 1386043677
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1475971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522281600000",
    "number": "1861942328",
    "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",
            "telephone_number": "631-359-5859",
            "fax_number": "631-396-0865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 ORIENT WAY",
            "city": "RUTHERFORD",
            "state": "NJ",
            "postal_code": "070702052",
            "telephone_number": "201-514-4900",
            "fax_number": "201-340-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL OCCUPATIONAL & PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-09",
        "last_updated": "2018-03-29",
        "status": "A",
        "authorized_official_last_name": "BRUSH",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "718-819-6805"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prestinemd
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• Pro Form Sports Medicine and Wellness Associates
• Prodigy Medical Management
• Professional Occupational & Physical Therapy, PLLC
• Professional Orthopedic and Sports Physical Therapy of NJ, LLC
• Professional Orthopedic and Sports Physical Therapy of NJ, LLC
• Prohealth Riverside Dental, LLC
• Robert Schorn Purnell, OD
• Raisa Sommers, LCSW, LLC

• Occupational Therapist in Rutherford, NJ
• Providers in Rutherford, NJ by specialty
• Occupational Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.