Individual provider Active NPI

Meagan Victoria Brossmann, OTR/L

  • Occupational Therapist
  • Hollywood, FL
National Provider Identifier
1992208128
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
19068 Issued in FL
Practice address
1 Oakwood Blvd
Hollywood, FL 33020-1956
Phone
(954) 925-3844
NPI assigned
Mar 14, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X FL
Occupational Therapist 225X00000X 19068 FL Primary

Addresses

Primary practice location

1 Oakwood Blvd
Hollywood, FL 33020-1956

Mailing address

18751 NW 5TH St
Pembroke Pines, FL 33029-3284
Phone (954) 297-1368

Other identifiers 1

IdentifierTypeStateIssuer
024898700MedicaidFL

Other names 1

  • Ms. Meagan Victoria Palermo Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
19068FLMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1520985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1992208128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18751 NW 5TH ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330293284",
            "telephone_number": "954-297-1368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 OAKWOOD BLVD",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330201956",
            "telephone_number": "954-925-3844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROSSMANN",
        "first_name": "MEAGAN",
        "middle_name": "VICTORIA",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-14",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "19068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024898700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEAGAN",
            "last_name": "PALERMO",
            "middle_name": "VICTORIA",
            "prefix": "MS.",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.