Individual provider Active NPI

Jessica Cusimano, OT

  • Occupational Therapist
  • Mitchellville, MD
National Provider Identifier
1639290679
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
04625 Issued in MD
Practice address
12140 Central Ave
Mitchellville, MD 20721-1932
Phone
(301) 581-8054
Fax
(301) 564-0284
NPI assigned
Apr 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 04625 MD Primary

Addresses

Primary practice location

12140 Central Ave
Mitchellville, MD 20721-1932

Mailing address

6410 Rockledge Dr
NRH Regional Rehab - Suite 600
Bethesda, MD 20817-1809
Phone (301) 581-8054

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

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639290679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6410 ROCKLEDGE DR",
            "address_2": "NRH REGIONAL REHAB - SUITE 600",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208171809",
            "telephone_number": "301-581-8054",
            "fax_number": "301-564-0284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12140 CENTRAL AVE",
            "city": "MITCHELLVILLE",
            "state": "MD",
            "postal_code": "207211932",
            "telephone_number": "301-581-8054",
            "fax_number": "301-564-0284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSIMANO",
        "first_name": "JESSICA",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "04625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mitchellville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.