Individual provider Active NPI

Michelle Angelique Dworakowski, OTR/L

  • Occupational Therapist
  • Leonardtown, MD
National Provider Identifier
1134422298
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
08270 Issued in MD
Practice address
21585 Peabody St
Leonardtown, MD 20650
Phone
(301) 475-8000
NPI assigned
Dec 13, 2010
Last updated
Mar 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 0119005267 VA
Occupational Therapist 225X00000X 08270 MD Primary

Addresses

Primary practice location

21585 Peabody St
Leonardtown, MD 20650

Mailing address

24095 Abells Run Dr
Hollywood, MD 20636-3217
Phone (703) 731-2546

Other practice location 1

102 Irving St NW
Washington, DC 20010-2921
Phone (301) 540-6140

Other practice location 2

2235 Tacketts Mill Dr # C
Woodbridge, VA 22192-3036
Phone (703) 491-1044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
08270MDMDSocial Worker
0119005267VAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Achievements, LLC Past 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1292198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1134422298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24095 ABELLS RUN DR",
            "city": "HOLLYWOOD",
            "state": "MD",
            "postal_code": "206363217",
            "telephone_number": "703-731-2546",
            "fax_number": "301-540-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21585 PEABODY ST",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "20650",
            "telephone_number": "301-475-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102 Irving St NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200102921",
            "country_code": "US",
            "telephone_number": "301-540-6140",
            "fax_number": "301-540-5190",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2235 Tacketts Mill Dr # C",
            "address_purpose": "LOCATION",
            "city": "Woodbridge",
            "state": "VA",
            "postal_code": "221923036",
            "country_code": "US",
            "telephone_number": "703-491-1044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DWORAKOWSKI",
        "first_name": "MICHELLE",
        "middle_name": "ANGELIQUE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-13",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119005267",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "08270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leonardtown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.