Individual provider Active NPI

Megumi Otake, OTR

  • Occupational Therapist
  • Cockeysville, MD
National Provider Identifier
1053975888
Registry record updated Apr 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
06030 Issued in MD
Practice address
300 International Cir
Cockeysville, MD 21030-1300
Phone
(410) 527-1111
NPI assigned
Apr 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2019

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 06030 MD Primary

Addresses

Primary practice location

300 International Cir
Cockeysville, MD 21030-1300

Mailing address

PO Box 680
Riderwood, MD 21139-0680
Phone (937) 602-3501

Other identifiers 1

IdentifierTypeStateIssuer
06030MedicaidMD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address assisted-rehab@comcast.net Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251211000026 MD Practitioner - Occupational Therapist in Private Practice 3779077359 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3908 N Charles St
Apt 1303
Baltimore, MD 21218-1757

PO Box
Suite 680
Riderwood, MD 21139

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06030MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Assisted Rehab. Incorporated Occupational Therapist CurrentSince Aug 28, 2025 Accepting new patients

Organizations & group practices 1

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": "1556236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556236800000",
    "number": "1053975888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 680",
            "city": "RIDERWOOD",
            "state": "MD",
            "postal_code": "211390680",
            "telephone_number": "937-602-3501",
            "fax_number": "214-305-3399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 INTERNATIONAL CIR",
            "city": "COCKEYSVILLE",
            "state": "MD",
            "postal_code": "210301300",
            "telephone_number": "410-527-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTAKE",
        "first_name": "MEGUMI",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-26",
        "last_updated": "2019-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "06030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06030",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "assisted-rehab@comcast.net",
            "affiliation": "N",
            "endpointDescription": "emaill address",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "assisted-rehab.com",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "website",
            "address_1": "300 International Cir",
            "city": "Cockeysville",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210301300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cockeysville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2019; 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.