Individual provider Active NPI

Michelle Kontarovich Alifarag, MS, OTR/L

  • Occupational Therapist
  • Philadelphia, PA
National Provider Identifier
1457758666
Registry record updated Jun 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OC017278 Issued in PA
Practice address
640 N Broad St Apt 415
Philadelphia, PA 19130-3439
Phone
(347) 439-8669
NPI assigned
Dec 3, 2014
Last updated
Jun 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 46TR00952600 NJ
Occupational Therapist 225X00000X 019319 NY
Occupational Therapist 225X00000X OC017278 PA Primary

Addresses

Primary practice location

640 N Broad St Apt 415
Philadelphia, PA 19130-3439

Mailing address

640 N Broad St Apt 415
Philadelphia, PA 19130-3439

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
46TR00952600NJMDOccupational Therapist
019319NYMDOccupational Therapist
OC017278PAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1417564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1457758666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 N BROAD ST APT 415",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191303439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 N BROAD ST APT 415",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191303439",
            "telephone_number": "347-439-8669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALIFARAG",
        "first_name": "MICHELLE",
        "middle_name": "KONTAROVICH",
        "credential": "MS, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-03",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00952600",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "019319",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC017278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2023; 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.