Benjamin McNulty, OTD, OTRL

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201013755 Issued in MI

Practice address

22731 Newman St Ste 100B
Dearborn, MI 48124-2023

Phone

(313) 791-0616

Fax

(313) 791-0632

NPI assigned

Jan 23, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Michigan Surgery Specialists P.C.

  • Occupational Medicine Clinic/Center
  • Warren, MI
  • NPI 1164411278
  NPD (past)

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

{
    "created_epoch": "1705968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1144082447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "253 SELKIRK ST",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481873927",
            "telephone_number": "734-751-7969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22731 NEWMAN ST STE 100B",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242023",
            "telephone_number": "313-791-0616",
            "fax_number": "313-791-0632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNULTY",
        "first_name": "BENJAMIN",
        "credential": "OTD, OTRL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-23",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201013755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley McNabb
• Lisa Latrease McNeal, BSW
• Martrell McNeal
• Monica McNeal
• Sean McNiff
• Shea Murphy McParlane, PA-C
• MD Hiller
• Nadia Meaat
• Ronald J Meade, MD
• Majlinda Meci, NP-C

• Occupational Therapist in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; 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.