Active NPI
Michael Christopher De Luca, OTRL
- Occupational Therapist
- Watertown, CT
National Provider Identifier
1538050752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 004795
- Practice address
- 41 Pheasant Ridge Dr
Watertown, CT 06795-1668 - Phone
- (203) 558-3895
- NPI assigned
- Jul 14, 2025
- Sex
- Male
- 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 Therapist | 225X00000X | 004795 | CT | Primary |
Addresses
Primary practice location
41 Pheasant Ridge Dr
Watertown, CT 06795-1668
Mailing address
41 Pheasant Ridge Dr
Watertown, CT 06795-1668
Phone (203) 558-3895
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260413001167 | CT | Practitioner - Occupational Therapist in Private Practice | 9537634001 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2017
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
41 Pheasant Ridge Dr
Watertown, CT 06795-1668
PO Box
Philadelphia, PA 19182
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1752451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752451200000",
"number": "1538050752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41 PHEASANT RIDGE DR",
"city": "WATERTOWN",
"state": "CT",
"postal_code": "067951668",
"telephone_number": "203-558-3895"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41 PHEASANT RIDGE DR",
"city": "WATERTOWN",
"state": "CT",
"postal_code": "067951668",
"telephone_number": "203-558-3895"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE LUCA",
"first_name": "MICHAEL",
"middle_name": "CHRISTOPHER",
"credential": "OTRL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-07-14",
"last_updated": "2025-07-14",
"certification_date": "2025-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CT",
"license": "004795",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Watertown, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; 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.