Individual provider Active NPI

Yetunde Tifase

  • Occupational Therapist
  • Pikesville, MD
National Provider Identifier
1225673023
Registry record updated Apr 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
08850 Issued in MD
Practice address
8301 Scotts Level Rd
Pikesville, MD 21208-2104
Phone
(410) 887-0763
NPI assigned
Nov 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2021

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 08850 MD Primary

Addresses

Primary practice location

8301 Scotts Level Rd
Pikesville, MD 21208-2104

Mailing address

8301 Scotts Level Rd
Pikesville, MD 21208-2104
Phone (410) 887-0763

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191210002273 MD Practitioner - Occupational Therapist in Private Practice 5294168928 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08850MDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Salus Capital Inc Occupational Therapist CurrentSince May 9, 2024 Accepting new patients

Locations

1020 Saint Paul St
Baltimore, MD 21202
Phone (410) 529-0348

4155 Glen Park Rd
Nottingham, MD 21236
Phone (347) 586-9519

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": "1573776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1225673023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8301 SCOTTS LEVEL RD",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212082104",
            "telephone_number": "410-887-0763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8301 SCOTTS LEVEL RD",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212082104",
            "telephone_number": "410-887-0763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIFASE",
        "first_name": "YETUNDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-15",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "08850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pikesville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.