Individual provider Active NPI

Kaitlyn Markovich

  • Occupational Therapy Assistant
  • Port Saint Lucie, FL
National Provider Identifier
1295609063
Registry record updated Oct 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA17745 Issued in FL
Practice address
631 SW Aster Rd
Port Saint Lucie, FL 34953-2906
Phone
(412) 897-7567
NPI assigned
Oct 3, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA17745 FL Primary

Addresses

Primary practice location

631 SW Aster Rd
Port Saint Lucie, FL 34953-2906

Mailing address

631 SW Aster Rd
Port Saint Lucie, FL 34953-2906

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OTA17745FLMDOccupational Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1759449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759449600000",
    "number": "1295609063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 SW ASTER RD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349532906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 SW ASTER RD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349532906",
            "telephone_number": "412-897-7567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKOVICH",
        "first_name": "KAITLYN",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-10-03",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA17745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.