Professional Occupational & Physical Therapy, PLLC
NPI 1104376680 · Occupational Therapist · Randolph, NJ
Enrolled with Medicare as Dme Supplier - Independently-Practicing Occupational Therapist · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Professional Occupational & Physical Therapy, PLLC is a Occupational Therapist organization in Randolph, NJ (NPI 1104376680).
Provider details
- NPI number
- 1104376680
- Entity type
- Organization
- Primary specialty
- Occupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Organization subpart
- No
- Authorized official
- Kathllen Brush, Credentialing Manager(631) 359-5859
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Physical Therapist225100000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2016-10-10
- Last updated
- 2019-04-23
Frequently asked questions
- What is Professional Occupational & Physical Therapy, PLLC's NPI number?
- Professional Occupational & Physical Therapy, PLLC's National Provider Identifier (NPI) is 1104376680, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Professional Occupational & Physical Therapy, PLLC?
- Professional Occupational & Physical Therapy, PLLC is classified in the NPPES registry as Occupational Therapist (Respiratory, Developmental, Rehabilitative and Restorative Service Providers).
- Where is Professional Occupational & Physical Therapy, PLLC located?
- Professional Occupational & Physical Therapy, PLLC's practice location on file with NPPES is 390 State Route 10 Ste 202, Randolph, NJ 07869-2141.
- What is Professional Occupational & Physical Therapy, PLLC's phone number?
- The practice phone number listed in the NPPES registry for Professional Occupational & Physical Therapy, PLLC is (973) 895-9925.
- Does Professional Occupational & Physical Therapy, PLLC accept Medicare?
- Professional Occupational & Physical Therapy, PLLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Professional Occupational & Physical Therapy, PLLC?
- The authorized official listed on Professional Occupational & Physical Therapy, PLLC's NPPES record is Kathllen Brush, Credentialing Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Professional Occupational & Physical Therapy, PLLC's NPI active?
- Yes — Professional Occupational & Physical Therapy, PLLC's NPI (1104376680) is active in the NPPES registry as of the last update on 2019-04-23.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.