Michael Centra

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

0119008514 Issued in VA

Practice address

1760 Old Meadow Road
Suite 205
McLean, VA 22102-4330

Phone

(703) 810-5214

NPI assigned

Apr 13, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, 1,921 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Annapolis, MD
  • NPI 1952461816

  DC

  Medicare reassignment Care Compare group NPD
• Orthovirginia Inc.

  • Multi-Specialty Clinic/Center
  • Fairfax, VA
  • NPI 1588066740

  DC

  Medicare reassignment NPD
• Orthovirginia, Inc

  • Multi-Specialty Clinic/Center
  • Reston, VA
  • NPI 1205185766

  Occupational Therapist

  NPD
• Orthovirginia, Inc

  • Physical Medicine & Rehabilitation Physician
  • Arlington, VA
  • NPI 1376411413
  NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Gaithersburg, MD
  • NPI 1831471713
  NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockville, MD
  • NPI 1962108753
  NPD

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

{
    "created_epoch": "1586736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1093334732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 BOULDERS PARKWAY",
            "address_2": "SUITE 200",
            "city": "N CHESTERFIELD",
            "state": "VA",
            "postal_code": "232254067",
            "telephone_number": "804-560-5595",
            "fax_number": "804-968-1803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 OLD MEADOW ROAD",
            "address_2": "SUITE 205",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "221024330",
            "telephone_number": "703-810-5214"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4901 Connecticut Ave NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200082022",
            "country_code": "US",
            "telephone_number": "202-966-7623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CENTRA",
        "first_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-13",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "DC",
            "license": "010001734",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119008514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequailty",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4901 Connecticut Ave NW",
            "city": "Washington",
            "state": "DC",
            "country_code": "US",
            "postal_code": "200082022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kim Allison Bullock, M.D.
• Stephen Edward Burch, DDS
• Maybelline Canela
• Samuel D. Cappiello, DDS
• Lillian Carol Carpio, D.D.S., M.S., PH.D.
• Melissa Sue Chaffee, M.D.
• Marcia A Chambers, PH.D.
• Courtney Myfanwy Chapman, M.D.
• Puja Suresh Charaipotra, P.T.
• Charlton Ho, D.D.S., P.L.L.C.

• Occupational Therapist in McLean, VA
• Providers in McLean, VA by specialty
• Occupational Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; 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.