Individual provider Active NPI

Kirby Masip

  • Occupational Therapist
  • Cedar Grove, NJ
National Provider Identifier
1912958109
Registry record updated Mar 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
46TR00336600 Issued in NJ
Practice address
81 Oak Dr
Cedar Grove, NJ 07009-1033
Phone
(973) 704-5758
Fax
(973) 785-0015
NPI assigned
May 13, 2006
Last updated
Mar 18, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 46TR00336600 NJ Primary

Addresses

Primary practice location

81 Oak Dr
Cedar Grove, NJ 07009-1033

Mailing address

81 Oak Dr
Cedar Grove, NJ 07009-1033
Phone (973) 785-0015

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060803000397 NJ Practitioner - Occupational Therapist in Private Practice 8224040738 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
46TR00336600NJMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Visiting Therapy Services LLC Occupational Therapist CurrentSince Apr 1, 2011 Accepting new patients
Seniorcare Rehab, LLC Occupational Therapist PastSince Jul 3, 2019 Accepting new patients

Locations

271 US Highway 46
Ste H111
Fairfield, NJ 07004
Phone (877) 887-3574

188 Newark Pompton Tpke
Little Falls, NJ 07424
Phone (877) 887-3574

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": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300406400000",
    "number": "1912958109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 OAK DR",
            "city": "CEDAR GROVE",
            "state": "NJ",
            "postal_code": "070091033",
            "telephone_number": "973-785-0015",
            "fax_number": "973-785-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 OAK DR",
            "city": "CEDAR GROVE",
            "state": "NJ",
            "postal_code": "070091033",
            "telephone_number": "973-704-5758",
            "fax_number": "973-785-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASIP",
        "first_name": "KIRBY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2011-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00336600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Grove, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2011; 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.