Individual provider Active NPI

Maximillian Myles Castoreno

  • Occupational Therapist
  • Sterling Heights, MI
National Provider Identifier
1194494658
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
459422 Issued in MI
Practice address
35735 Mound Rd
Sterling Heights, MI 48310-4728
Phone
(586) 510-7997
NPI assigned
Sep 8, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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 459422 MI Primary

Addresses

Primary practice location

35735 Mound Rd
Sterling Heights, MI 48310-4728

Mailing address

26420 W Warren St
Dearborn Heights, MI 48127-1944
Phone (313) 676-7397

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220414001087 MI Practitioner - Occupational Therapist in Private Practice 1355737552 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mendelson Orthopedics PCGroup PAC ID 8426008368, 69 clinicians

Practice addresses (Care Compare)

36622 5 Mile Rd
Livonia, MI 48154-1900
Phone (734) 542-0200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
459422MIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mendelson Orthopedics PC Current Accepting new patients
Mendelson Orthopedics PC CurrentSince Jun 6, 2022 Accepting new patients
Mendelson Orthopedics PC CurrentSince Jun 6, 2022 Accepting new patients

Locations

7684 Solutions Ctr
#777684
Chicago, IL 60677

36622 5 Mile Rd
Livonia, MI 48154
Phone (734) 542-0200

35735 Mound Rd
Ste 101
Sterling Heights, MI 48310
Phone (586) 510-7997

35735 Mound Rd
Sterling Heights, MI 48310
Phone (586) 261-1960

13488 E 11 Mile Rd
Warren, MI 48089
Phone (586) 439-6243

Organizations & group practices 3

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": "1631059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1194494658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26420 W WARREN ST",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481271944",
            "telephone_number": "313-676-7397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35735 MOUND RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483104728",
            "telephone_number": "586-510-7997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTORENO",
        "first_name": "MAXIMILLIAN",
        "middle_name": "MYLES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-08",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "459422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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.