Individual provider Active NPI

Maricely Dufault

  • Occupational Therapy Assistant
  • Frederick, MD
National Provider Identifier
1356807648
Registry record updated Aug 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
A02636 Issued in MD
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

Updated by the provider on Aug 14, 2026

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 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 Former name

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
A02636MDMDOccupational 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.

Verify at the official NPI Registry.