STEPHANIE A KENNEALLY (MOT, OTR/L) – Contractor, NPI 1104101617

STEPHANIE A KENNEALLY (MOT, OTR/L) is a healthcare provider. based in Monroe, New Jersey. specializing in OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials MOT, OTR/L. They hold a License No. 46TR0542000 (NJ). The NPI Number for STEPHANIE A KENNEALLY (MOT, OTR/L) is 1104101617

Main info

Female
Sole Proprietor
15 Years Of Experience
Accepts Medicare Assignment
Name
STEPHANIE A KENNEALLY (MOT, OTR/L)
NPI
1104101617
Phone
(732) 266-8814
Address
257B MATCHAPONIX AVE
Enumeration Date
15 October 2011
Last Update Date
9 April 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7329873833
Graduation Year
2011 (15 years ago)
PAC ID
2163697871
Group Practice PAC ID
4183033210
Professional Enrollment ID
I20111208000135
Address ID
NJ076016451HA411XXAVEX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:14State licenses:1Digital endpointsOther names

1,269 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in NJ

Provider Addresses for STEPHANIE A KENNEALLY (MOT, OTR/L)

  • 257B MATCHAPONIX AVE

    MONROE, NJ 088314034

    Phone: (732) 266-8814

    Type: Mailing

  • 40 CANTERBURY DR

    FREEHOLD, NJ 077284421

    Phone: (732) 266-8814

    Type: Location

  • 38 Hillwood Rd

    East Brunswick, NJ 088164622

    Phone: (732) 266-8814

    Type: Location

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: 2011-12-08

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
I20111208000135IOccupational 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 08831)

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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 PracticeNJ
Occupational Therapist In Private PracticeNY
Occupational Therapist In Private PracticeNJ
Physical Therapist In Private PracticeNJ

Reviews

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Frequently asked questions

How do I look up STEPHANIE A KENNEALLY (MOT, OTR/L) by NPI?
Use NPI 1104101617 when you need to reference STEPHANIE A KENNEALLY (MOT, OTR/L) in forms, claims, or directories.
Does this profile mean STEPHANIE A KENNEALLY (MOT, OTR/L) is currently active?
Yes — STEPHANIE A KENNEALLY (MOT, OTR/L) appears active in the national provider directory.
What kind of provider is STEPHANIE A KENNEALLY (MOT, OTR/L)?
The page reflects Contractor for STEPHANIE A KENNEALLY (MOT, OTR/L). Clinical services aligned with this taxonomy classification.
What location shows for STEPHANIE A KENNEALLY (MOT, OTR/L)?
We surface Monroe, New Jersey for STEPHANIE A KENNEALLY (MOT, OTR/L) based on available NPPES addresses.
How can I contact STEPHANIE A KENNEALLY (MOT, OTR/L)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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