Active NPI
Michael Leduc, MOT/OTR/L
- Occupational Therapist
- Fairfield, CA
National Provider Identifier
1679977102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT-1910
- Practice address
- 101 Bodin Cir
Fairfield, CA 94535-1809 - Phone
- (707) 423-7899
- NPI assigned
- Oct 13, 2014
- 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 | OT-1910 | HI | Primary |
Addresses
Primary practice location
101 Bodin Cir
Fairfield, CA 94535-1809
Mailing address
101 Bodin Cir
Fairfield, CA 94535-1809
Phone (707) 423-7899
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT-1910 | HI | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| M&M Wheelchairs | 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.
-
- Customized Equipment (DME)
- Kapolei, HI
- NPI 1841770203
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721952000000",
"number": "1679977102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 BODIN CIR",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945351809",
"telephone_number": "707-423-7899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 BODIN CIR",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945351809",
"telephone_number": "707-423-7899"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEDUC",
"first_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "MOT/OTR/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-10-13",
"last_updated": "2024-07-26",
"certification_date": "2024-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": "HI",
"license": "OT-1910",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.