Marianne Gonzales De Castro

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

07548 Issued in MD

Practice address

301 Russell Ave
Gaithersburg, MD 20877-2800

Phone

(301) 216-4247

NPI assigned

Nov 22, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1479772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551916800000",
    "number": "1649713736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2490 SUN VALLEY CIR",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209062230",
            "telephone_number": "202-999-7944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 RUSSELL AVE",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208772800",
            "telephone_number": "301-216-4247"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4922 LaSalle Rd",
            "address_purpose": "LOCATION",
            "city": "Hyattsville",
            "state": "MD",
            "postal_code": "207823302",
            "country_code": "US",
            "telephone_number": "301-864-2333 x1150",
            "fax_number": "877-882-8206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE CASTRO",
        "first_name": "MARIANNE",
        "middle_name": "GONZALES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-22",
        "last_updated": "2019-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "07548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 2 (ORGANIZATION NPI)",
            "identifier": "1447657507",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4374045-00",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Occupational Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2019; 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.