Individual provider Active NPI

Lydia Nemirovsky, MS, OTR/L

  • Occupational Therapist
  • Elkridge, MD
National Provider Identifier
1053798140
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
07124 Issued in MD
Practice address
8008 Nightwind CT
Elkridge, MD 21075-6463
Phone
(443) 472-2449
NPI assigned
Apr 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 07124 MD Primary

Addresses

Primary practice location

8008 Nightwind CT
Elkridge, MD 21075-6463

Mailing address

8008 Nightwind CT
Elkridge, MD 21075-6463
Phone (443) 472-2449

Other identifiers 1

IdentifierTypeStateIssuer
487207000MedicaidMD

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://spmsmaryland.com/?page_id=7911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190520000329 MD Practitioner - Occupational Therapist in Private Practice 3476896283 Reassigns benefits to 2 organizations
I20190520000364 DC Practitioner - Occupational Therapist in Private Practice 3476896283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Elkridge, MD 21075
Phone (410) 404-6071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehab OT MD LLC Occupational Therapist CurrentSince Apr 1, 2019 Accepting new patients
Fox Rehabilitation Services LLC Occupational Therapist CurrentSince Apr 1, 2019 Accepting new patients

Locations

11665 Doolittle Dr
Waldorf, MD 20602
Phone (301) 638-4100

7 Carnegie Plz
Cherry Hill, NJ 08003

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1430179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1053798140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8008 NIGHTWIND CT",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210756463",
            "telephone_number": "443-472-2449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8008 NIGHTWIND CT",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210756463",
            "telephone_number": "443-472-2449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEMIROVSKY",
        "first_name": "LYDIA",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-28",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "07124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "487207000",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://spmsmaryland.com/?page_id=7911",
            "affiliation": "N",
            "endpointDescription": "Providers can upload all documents safely and securely through this HIPAA secure portal",
            "address_1": "8008 Nightwind Ct",
            "city": "Elkridge",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210756463",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elkridge, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.