Active NPI
Maricely Dufault
- Occupational Therapy Assistant
- Frederick, MD
National Provider Identifier
1356807648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- A02636
- Practice address
- 30 North PL
Frederick, MD 21701-6200 - Phone
- (301) 695-6618
- NPI assigned
- Feb 12, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | A02636 | MD | Primary |
Addresses
Primary practice location
30 North PL
Frederick, MD 21701-6200
Mailing address
606 Eisenhower Dr
Frederick, MD 21703-8445
Other practice location 1
7407 Willow Rd
Frederick, MD 21702-2595
Phone (301) 644-5600
Other practice location 2
4640 Wedgewood Blvd
Frederick, MD 21703-7114
Phone (240) 457-9558
Other names 1
- Maricely Beja
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
| License | State | Type | Specialty |
|---|---|---|---|
| A02636 | MD | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786665600000",
"number": "1356807648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "606 EISENHOWER DR",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217038445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 NORTH PL",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217016200",
"telephone_number": "301-695-6618"
}
],
"practiceLocations": [
{
"address_1": "7407 Willow Rd",
"address_purpose": "LOCATION",
"city": "Frederick",
"state": "MD",
"postal_code": "217022595",
"country_code": "US",
"telephone_number": "301-644-5600",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4640 Wedgewood Blvd",
"address_purpose": "LOCATION",
"city": "Frederick",
"state": "MD",
"postal_code": "217037114",
"country_code": "US",
"telephone_number": "240-457-9558",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DUFAULT",
"first_name": "MARICELY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-02-12",
"last_updated": "2026-08-14",
"certification_date": "2026-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "MD",
"license": "A02636",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARICELY",
"last_name": "BEJA",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Frederick, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.