Individual provider Active NPI

David Kamunyo Miringu, OCCUPATION THERAPIST

  • Occupational Therapist
  • Chelmsford, MA
National Provider Identifier
1235596396
Registry record updated Sep 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
12511 Issued in MA
Practice address
206 North Road
Chelmsford, MA 01824-4832
Phone
(713) 748-9128
Fax
(978) 319-9277
NPI assigned
Jan 20, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2020

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 12511 MA Primary

Addresses

Primary practice location

206 North Road
Chelmsford, MA 01824-4832

Mailing address

206 North Road
Chelmsford, MA 01824-4832
Phone (713) 748-9128

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260604001792 MA Practitioner - Occupational Therapist in Private Practice 6406327097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1990
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

206 N Rd
Chelmsford, MA 01824-1638

PO Box
821322 Attn Powerback Credentialing Dept
Philadelphia, PA 19182-1322

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12511MAMDOccupational Therapist

Organizations & group practices 1

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": "1453248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1235596396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 NORTH ROAD",
            "city": "CHELMSFORD",
            "state": "MA",
            "postal_code": "018244832",
            "telephone_number": "713-748-9128",
            "fax_number": "978-319-9277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 NORTH ROAD",
            "city": "CHELMSFORD",
            "state": "MA",
            "postal_code": "018244832",
            "telephone_number": "713-748-9128",
            "fax_number": "978-319-9277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRINGU",
        "first_name": "DAVID",
        "middle_name": "KAMUNYO",
        "name_prefix": "Mr.",
        "credential": "OCCUPATION THERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-20",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "12511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chelmsford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; 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.