Professional Occupational & Physical Therapy, PLLC
NPI 1104376680ActiveOrganization· Occupational Therapist· Randolph, NJ
Occupational Therapist in Randolph, New Jersey, registered in NPPES in October 2016. The authorized official on file is Kathllen Brush, Credentialing Manager. Enrolled in Medicare as dme supplier - independently-practicing occupational therapist.
Overview
| NPI | 1104376680 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 10, 2016 |
| Last updated in NPPES | Apr 23, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Occupational Therapist Primary | 225X00000X | — | — |
| Physical Therapist | 225100000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Independently-Practicing Occupational Therapist (NJ) |
|---|
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