Individual provider Active NPI

Frank Digiovannantonio, CHT

  • Occupational Therapist
  • Waldorf, MD
National Provider Identifier
1194712190
Registry record updated May 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
02649 Issued in MD
Practice address
10 Saint Patricks Dr
Suite 401
Waldorf, MD 20603-4527
Phone
(301) 870-7366
Fax
(301) 870-6717
NPI assigned
Oct 4, 2005
Last updated
May 15, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2012

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 02649 MD Primary

Addresses

Primary practice location

10 Saint Patricks Dr
Suite 401
Waldorf, MD 20603-4527

Mailing address

10 Saint Patricks Dr
Suite 401
Waldorf, MD 20603-4527
Phone (301) 870-7366

Other identifiers 1

IdentifierTypeStateIssuer
796704700MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20121012000301 MD Practitioner - Occupational Therapist in Private Practice 3870758444 Reassigns benefits to 1 organization
I20260422000384 DC Practitioner - Occupational Therapist in Private Practice 3870758444 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proflex Physical Therapy of Maryland, LLCGroup PAC ID 7416244322, 41 clinicians

Practice addresses (Care Compare)

22715 Washington St
Leonardtown, MD 20650-0309
Phone (301) 997-0172

3320 Crain Hwy
Waldorf, MD 20603-4850
Phone (301) 870-7366

7905 Malcolm Rd
Suite 201
Clinton, MD 20735-1749
Phone (301) 856-0050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
02649MDMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Maryland Physical Therapy, Inc PastSince Aug 1, 2012 Accepting new patients
Proflex Physical Therapy of Maryland, LLC Past Accepting new patients

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, 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": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337040000000",
    "number": "1194712190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 SAINT PATRICKS DR",
            "address_2": "SUITE 401",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034527",
            "telephone_number": "301-870-7366",
            "fax_number": "301-870-6717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 SAINT PATRICKS DR",
            "address_2": "SUITE 401",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034527",
            "telephone_number": "301-870-7366",
            "fax_number": "301-870-6717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIGIOVANNANTONIO",
        "first_name": "FRANK",
        "name_prefix": "Mr.",
        "credential": "CHT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2012-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "02649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "796704700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2012; 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.