KELLY ANDREASSI (OT/R) – Student in an Organized Health Care Education/Training Program, NPI 1073966404

KELLY ANDREASSI (OT/R) is a healthcare provider. based in Glassboro, New Jersey. specializing in OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials OT/R. The NPI Number for KELLY ANDREASSI (OT/R) is 1073966404

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
KELLY ANDREASSI (OT/R)
NPI
1073966404
Phone
(856) 371-9521
Address
28 ELM CT
Enumeration Date
20 July 2016
Last Update Date
22 March 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7329873833
Graduation Year
2021 (5 years ago)
PAC ID
3375935133
Group Practice PAC ID
4183033210
Professional Enrollment ID
I20220908001761
Address ID
NJ076016451HA411XXAVEX301

Contacts

Secure Messaging
backtometherapy@protonmail.com
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience33
Completeness85
Years active:9State licenses:0Other namesUpdated within 12 months

1,269 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in NJ

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Provider Addresses for KELLY ANDREASSI (OT/R)

  • 28 ELM CT

    GLASSBORO, NJ 080282858

    Phone: (856) 371-9521

    Type: Mailing

  • 28, Elm Court, Glassboro, Gloucester County, New Jersey, 08028, United States

    GLASSBORO, NJ 080282858

    Phone: (856) 371-9521

    Type: Location

  • 816 DELSEA DR N STE 130

    GLASSBORO, NJ 080281438

    Phone: (856) 371-9521

    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: 2022-09-08

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
I20220908001761IOccupational Therapist In Private PracticeNJTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 08028)

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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: 4183033210View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeNJ
Qualified Speech Language PathologistNJ
Occupational Therapist In Private PracticeIL
Physical Therapist In Private PracticeNJ
Occupational Therapist In Private PracticeNJ
Physical Therapist In Private PracticeNY
Occupational Therapist In Private PracticeNY
Occupational Therapist In Private PracticeNJ
Occupational Therapist In Private PracticeNJ
Physical Therapist In Private PracticeNJ

Reviews

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Frequently asked questions

Can I use this page to confirm KELLY ANDREASSI (OT/R)'s NPI?
Yes. KELLY ANDREASSI (OT/R) is listed with NPI 1073966404 in the public NPI dataset.
Is KELLY ANDREASSI (OT/R) listed as active for patients and plans?
The listing shows KELLY ANDREASSI (OT/R) as active in the NPI system.
What taxonomy line describes KELLY ANDREASSI (OT/R)?
For research purposes, treat KELLY ANDREASSI (OT/R) as Student in an Organized Health Care Education/Training Program in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect KELLY ANDREASSI (OT/R) on a map?
Expect Glassboro, New Jersey as a primary anchor for KELLY ANDREASSI (OT/R) unless the record lists multiple sites.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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