Active NPI
Maricor Dillera, PT
- Physical Therapist
- Gaithersburg, MD
National Provider Identifier
1154936847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 9366 Gaither Rd
Gaithersburg, MD 20877-1416 - Phone
- (301) 383-3019
- NPI assigned
- Sep 10, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
9366 Gaither Rd
Gaithersburg, MD 20877-1416
Mailing address
9204 Frostburg Way
Montgomery Village, MD 20886-1452
Phone (301) 383-3019
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26302 | MD | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599696000000",
"number": "1154936847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9204 FROSTBURG WAY",
"city": "MONTGOMERY VILLAGE",
"state": "MD",
"postal_code": "208861452",
"telephone_number": "301-383-3019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9366 GAITHER RD",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208771416",
"telephone_number": "301-383-3019"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DILLERA",
"first_name": "MARICOR",
"name_prefix": "Ms.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-10",
"last_updated": "2020-09-10",
"certification_date": "2020-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gaithersburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.