Individual provider Active NPI

Jessica Lynn Veneziano, OTR/L, OTD

  • Occupational Therapist
  • Middletown, NJ
National Provider Identifier
1912668286
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
1275 Highway 35 Ste 7
Middletown, NJ 07748-2000
Phone
(732) 639-0068
NPI assigned
Jan 7, 2022
Last updated
Oct 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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 22594 FL
Occupational Therapist 225X00000X NJ Primary

Addresses

Primary practice location

1275 Highway 35 Ste 7
Middletown, NJ 07748-2000

Mailing address

708 Oceanside Cir
Ruskin, FL 33570-4586
Phone (732) 673-2050

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220407000756 NJ Practitioner - Occupational Therapist in Private Practice 2668868233 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

Practice addresses (Care Compare)

443 Hwy 34
Suite J
Matawan, NJ 07747-9506
Phone (732) 639-0068

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22594FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therafit Enterprises of New Jersey Incorporated Occupational Therapist CurrentSince Jul 27, 2022 Accepting new patients
Therafit Enterprises of New Jersey Incorporated Occupational Therapist CurrentSince Jul 27, 2022 Accepting new patients

Locations

443 Highway 34
Ste J
Matawan, NJ 07747
Phone (732) 639-0068

1275 Highway 35
Ste 7
Middletown, NJ 07748
Phone (732) 639-0068

Organizations & group practices 2

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": "1641513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1912668286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 OCEANSIDE CIR",
            "city": "RUSKIN",
            "state": "FL",
            "postal_code": "335704586",
            "telephone_number": "732-673-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 HIGHWAY 35 STE 7",
            "city": "MIDDLETOWN",
            "state": "NJ",
            "postal_code": "077482000",
            "telephone_number": "732-639-0068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENEZIANO",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "OTR/L, OTD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-07",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "22594",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; 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.