Individual provider Active NPI

Monica Tomasello

  • Occupational Therapist
  • Williams Bay, WI
National Provider Identifier
1932644358
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
940 Issued in SC
Practice address
68 Orchard St
Williams Bay, WI 53191-9708
Phone
(262) 203-4963
NPI assigned
Dec 20, 2016
Last updated
Dec 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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 2602-26 WI
Occupational Therapist 225X00000X 940 SC Primary

Addresses

Primary practice location

68 Orchard St
Williams Bay, WI 53191-9708

Mailing address

484 Fox LN
Walworth, WI 53184-9792
Phone (262) 203-4963

Other practice location 1

484 Fox Ln
Walworth, WI 53184-9792
Phone (262) 203-4963

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230829004542 SC Practitioner - Occupational Therapist in Private Practice 7113284266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comprehensive Therapeutics LTDGroup PAC ID 8921230137, 324 clinicians

Practice addresses (Care Compare)

101 Park CT
Gaffney, SC 29341-1275
Phone (864) 206-4237

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
940SCMDOccupational Therapist
2602-26WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Therapeutics LTD Occupational Therapist CurrentSince Jul 17, 2023 Accepting new patients

Locations

101 Park Ct
Gaffney, SC 29341
Phone (843) 800-2754

1 Marcus Dr
Ste 102
Greenville, SC 29615

Organizations & group practices 1

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": "1482192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1932644358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "484 FOX LN",
            "city": "WALWORTH",
            "state": "WI",
            "postal_code": "531849792",
            "telephone_number": "262-203-4963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 ORCHARD ST",
            "city": "WILLIAMS BAY",
            "state": "WI",
            "postal_code": "531919708",
            "telephone_number": "262-203-4963"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "484 Fox Ln",
            "address_purpose": "LOCATION",
            "city": "Walworth",
            "state": "WI",
            "postal_code": "531849792",
            "country_code": "US",
            "telephone_number": "262-203-4963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOMASELLO",
        "first_name": "MONICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-20",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "2602-26",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williams Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; 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.