NPIMap

Individual provider Active NPI

Ann Kristine Aquino Tan, OTR/L

  • Occupational Therapist
  • Adelphi, MD
National Provider Identifier
1619308376
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
07117 Issued in MD
Practice address
7411 Riggs Rd Ste 308
Adelphi, MD 20783-4246
Phone
(301) 864-2333
NPI assigned
Dec 6, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X
Occupational Therapist 225X00000X 07117 MD Primary

Addresses

Primary practice location

7411 Riggs Rd Ste 308
Adelphi, MD 20783-4246

Mailing address

7411 Riggs Rd Ste 308
Adelphi, MD 20783-4246
Phone (301) 864-2333

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
07117MDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Icare Mobile Wound Care VA PLLC Current Accepting new patients

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": "1386288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1619308376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7411 RIGGS RD STE 308",
            "city": "ADELPHI",
            "state": "MD",
            "postal_code": "207834246",
            "telephone_number": "301-864-2333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7411 RIGGS RD STE 308",
            "city": "ADELPHI",
            "state": "MD",
            "postal_code": "207834246",
            "telephone_number": "301-864-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "ANN KRISTINE",
        "middle_name": "AQUINO",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-06",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "07117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Adelphi, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2024; 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.