Individual provider Active NPI

Ibrahim Kuteyi, OTR/L

  • Occupational Therapist
  • Hyattsville, MD
National Provider Identifier
1205252194
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
09637 Issued in MD
Practice address
1051 Brightseat Rd
Hyattsville, MD 20785-3738
Phone
(240) 487-4400
NPI assigned
Mar 15, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 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 09637 MD Primary

Addresses

Primary practice location

1051 Brightseat Rd
Hyattsville, MD 20785-3738

Mailing address

1051 Brightseat Rd
Hyattsville, MD 20785-3738
Phone (240) 487-4400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251006002002 MD Practitioner - Occupational Therapist in Private Practice 7618473877 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prime Light Health ServicesGroup PAC ID 9931624079, 6 clinicians

Practice addresses (Care Compare)

Edgewood, MD 21040
Phone (443) 857-7475

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
09637MDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mary'S House of Greater Washington, Inc. Current Accepting new patients
Prime Light Health Services Occupational Therapist CurrentSince Jul 10, 2025 Accepting new patients

Locations

1319 Woodbridge Station Way
Ste 101
Edgewood, MD 21040
Phone (443) 857-7475

Organizations & group practices 2

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": "1394841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1205252194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 BRIGHTSEAT RD",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207853738",
            "telephone_number": "240-487-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 BRIGHTSEAT RD",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207853738",
            "telephone_number": "240-487-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUTEYI",
        "first_name": "IBRAHIM",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-15",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "09637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyattsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.