Maura Kathryn Iacobucci, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

056011801 Issued in IL

Practice address

111 Washington St FL 2
Hoboken, NJ 07030-7796

Phone

(201) 808-2245

NPI assigned

Jan 17, 2017

Last updated

Jan 10, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Spear Physical and Occupational Therapy, LLC

  • Physical Therapist
  • Hoboken, NJ
  • NPI 1770258857

  Occupational Therapist

  NPD

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

{
    "created_epoch": "1484611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1871039677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 N CATHERINE AVE",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "605255930",
            "telephone_number": "708-482-9453",
            "fax_number": "708-482-9454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 WASHINGTON ST FL 2",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070307796",
            "telephone_number": "201-808-2245"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "57 W 57th St Fl 15",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100192832",
            "country_code": "US",
            "telephone_number": "646-790-7464",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18 N Catherine Ave",
            "address_purpose": "LOCATION",
            "city": "LA Grange",
            "state": "IL",
            "postal_code": "605255930",
            "country_code": "US",
            "telephone_number": "708-482-9453",
            "fax_number": "708-482-9454",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IACOBUCCI",
        "first_name": "MAURA",
        "middle_name": "KATHRYN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-17",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "025011",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00945900",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056011801",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IL",
            "license": "056011801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DO NOT TREAT MEDICAID OR MEDICARE PATIENTS",
            "identifier": "1972691244",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Humc Opco, LLC (Hoboken University Hospital)
• Catherine Hunt, M.S., CCC-SLP
• Charles David Hunt, M.D.
• Heather Hyon, PA-C
• Hyperoptics, Inc.
• N. Lucia Iadinardi, LAC
• Amal Ibrahim Kazaure, MD
• Hanadi Salah Ibrahim
• Zein Tarek Ibrahim
• Kathleen Ierace, PT, DPT

• Pediatric Occupational Therapist in Hoboken, NJ
• Providers in Hoboken, NJ by specialty
• Pediatric Occupational Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; 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.