Individual provider Active NPI

Jonathan N Guzman, OT

  • Occupational Therapist
  • Falls Church, VA
National Provider Identifier
1366991960
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0119006600 Issued in VA
Practice address
2841 Hartland Rd Ste 403
Falls Church, VA 22043-3500
Phone
(703) 646-2250
Fax
(703) 991-5649
NPI assigned
Sep 25, 2016
Last updated
Jul 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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 0119006600 VA Primary

Addresses

Primary practice location

2841 Hartland Rd Ste 403
Falls Church, VA 22043-3500

Mailing address

41703 McMonagle SQ
Aldie, VA 20105-6028
Phone (703) 646-2250

Other practice location 1

46090 Lake Center Plz Ste 303
Sterling, VA 20165-5879
Phone (571) 771-3130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20161107002438 DC Practitioner - Occupational Therapist in Private Practice 9335428747 Reassigns benefits to 2 organizations
I20161111001876 VA Practitioner - Occupational Therapist in Private Practice 9335428747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Howard University College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1221 Mercantile LN
Largo, MD 20774-5374
Phone (301) 618-5700

12255 Fair Lakes Pkwy
Fairfax, VA 22033-3952
Phone (703) 237-4800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0119006600VAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Mar 29, 2021 Accepting new patients
Allied Health Solutions LLC Occupational Therapist CurrentSince Jun 1, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Current Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Mar 29, 2021 Accepting new patients

Locations

2101 E Jefferson St
Ste 6WPPQA
Rockville, MD 20852
Phone (301) 816-5853

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

2841 Hartland Rd
Ste 403
Falls Church, VA 22043
Phone (703) 646-2250

46090 Lake Center Plz
Ste 303
Sterling, VA 20165
Phone (571) 771-3130

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1474761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1366991960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41703 MCMONAGLE SQ",
            "city": "ALDIE",
            "state": "VA",
            "postal_code": "201056028",
            "telephone_number": "703-646-2250",
            "fax_number": "703-991-5649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2841 HARTLAND RD STE 403",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220433500",
            "telephone_number": "703-646-2250",
            "fax_number": "703-991-5649"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "46090 Lake Center Plz Ste 303",
            "address_purpose": "LOCATION",
            "city": "Sterling",
            "state": "VA",
            "postal_code": "201655879",
            "country_code": "US",
            "telephone_number": "571-771-3130",
            "fax_number": "703-991-5649",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUZMAN",
        "first_name": "JONATHAN",
        "middle_name": "N",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-25",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119006600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Falls Church, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; 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.