JACQUELINE KAY NIZAMOFF (OTR CHT) – Hand Occupational Therapist, NPI 1003942111

JACQUELINE KAY NIZAMOFF (OTR CHT) is a healthcare provider. based in Fleming island, Florida. specializing in OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials OTR CHT. They hold a License No. 2660 (FL). The NPI Number for JACQUELINE KAY NIZAMOFF (OTR CHT) is 1003942111

Main info

Female
Sole Proprietor
37 Years Of Experience
Accepts Medicare Assignment
Name
JACQUELINE KAY NIZAMOFF (OTR CHT)
NPI
1003942111
Phone
(904) 215-6122
Address
1715 EAGLE HARBOR PKWY STE A
Enumeration Date
25 February 2007
Last Update Date
21 July 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9042152422
Graduation Year
1989 (37 years ago)
PAC ID
2062543085
Group Practice PAC ID
2769381391
Professional Enrollment ID
I20100708000102
Address ID
FL320034324FL1715XPKWY401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,139 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in FL

Provider Addresses for JACQUELINE KAY NIZAMOFF (OTR CHT)

  • 1715 EAGLE HARBOR PKWY STE A

    FLEMING ISLAND, FL 320034324

    Phone: (904) 215-6122

    Fax: (904) 375-8627

    Type: Location

  • 11945 SAN JOSE BLVD STE 300

    JACKSONVILLE, FL 322231627

    Phone: (904) 396-1725

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-07-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100708000102IOccupational Therapist In Private PracticeFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes11225$0
97140Therapy procedure using manual technique, each 15 minutes4122$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes3822$0
View full utilization report →

Insurance plans in this area (ZIP 32003)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2769381391View full group profile
NameSpecialtyState
O T O L A R Y N G O L O G YPA
Otolaryngology, General SurgeryFL
O T O L A R Y N G O L O G YKY
General Surgery, Critical Care (Intensivists)FL
Orthopedic SurgeryFL
Otolaryngology, Sleep MedicineFL
General SurgeryFL
General SurgeryFL
O P H T H A L M O L O G YFL
Pain ManagementFL

Reviews

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Frequently asked questions

What is the 10-digit NPI for JACQUELINE KAY NIZAMOFF (OTR CHT)?
JACQUELINE KAY NIZAMOFF (OTR CHT) — NPI 1003942111 — is the standard way to identify this listing.
Does the file indicate JACQUELINE KAY NIZAMOFF (OTR CHT) is practicing under active NPI?
Directory data currently reports JACQUELINE KAY NIZAMOFF (OTR CHT) as active.
What healthcare role does JACQUELINE KAY NIZAMOFF (OTR CHT) hold?
Scheduling teams often label JACQUELINE KAY NIZAMOFF (OTR CHT) under Hand Occupational Therapist. Clinical services aligned with this taxonomy classification.
What address line appears for JACQUELINE KAY NIZAMOFF (OTR CHT)?
JACQUELINE KAY NIZAMOFF (OTR CHT)'s geographic hint is Fleming Island, Florida in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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