Kathleen Siobhan Evangelista, MS OTR/L in West Orange, NJ - Medicare Occupational Therapist Provider

Kathleen Siobhan Evangelista, MS OTR/L is a medicare enrolled "Occupational Therapist" provider in West Orange, New Jersey. Her current practice location is 622 Eagle Rock Ave Ste 108, West Orange, New Jersey. You can reach out to her office (for appointments etc.) via phone at (973) 669-0072.

Kathleen Siobhan Evangelista is licensed to practice in New Jersey (license number 46TR00559400) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1265778856.

Contact Information

	Kathleen Siobhan Evangelista, MS OTR/L
	622 Eagle Rock Ave Ste 108, West Orange, NJ 07052-2994
	(973) 669-0072
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Kathleen Siobhan Evangelista
Gender	Female
Speciality	Occupational Therapist
Location	622 Eagle Rock Ave Ste 108, West Orange, New Jersey
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1265778856
Provider Enumeration Date: 12/31/2012
Last Update Date: 01/10/2023

Medicare PECOS Information:

PECOS PAC ID: 5890167688
Enrollment ID: I20230203000705

Medical Identifiers

Medical identifiers for Kathleen Siobhan Evangelista such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1265778856	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225X00000X	Occupational Therapist	46TR00559400 (New Jersey)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kathleen Siobhan Evangelista allows following entities to bill medicare on her behalf.

Provider Name	Fox Rehabilitation Services Inc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1326092503 PECOS PAC ID: 0143133009 Enrollment ID: O20150303000554

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kathleen Siobhan Evangelista is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Kathleen Siobhan Evangelista, MS OTR/L 3 Butler Ln, West Milford, NJ 07480-1307 Ph: () -	Kathleen Siobhan Evangelista, MS OTR/L 622 Eagle Rock Ave Ste 108, West Orange, NJ 07052-2994 Ph: (973) 669-0072

Reviews and Comments

Occupational Therapist in West Orange, NJ

Kevin Mukalel, OTD Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 563 Northfield Ave, West Orange, NJ 07052 Phone: 973-243-2060
Alyssa Marie Attanasio, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1199 Pleasant Valley Way, West Orange, NJ 07052 Phone: 973-414-4755
Rachel Dionna Portee, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1094 Smith Manor Blvd, West Orange, NJ 07052 Phone: 609-845-4776
Julianne Couch, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1199 Pleasant Valley Way, West Orange, NJ 07052 Phone: 973-414-4755
Mary Cabarle, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1199 Pleasant Valley Way, West Orange, NJ 07052 Phone: 973-414-4755 Fax: 973-243-6967
Syndi Lyn Granger, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1199 Pleasant Valley Way, West Orange, NJ 07052 Phone: 973-414-4755
Katherine Mcguire, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1155 Pleasant Valley Way, West Orange, NJ 07052 Phone: 973-731-5100

Kathleen Siobhan Evangelista, MS OTR/L - Medicare Occupational Therapist in West Orange, NJ