Active NPI
Jack Penafiel, OTAL
- Occupational Therapist
- Baltimore, MD
National Provider Identifier
1861607384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- A00483
- Practice address
- 7960 Scott Level
Baltimore, MD 21208 - Phone
- (410) 521-3600
- NPI assigned
- May 10, 2007
- Sex
- Male
- Sole proprietor
- No
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 | A00483 | MD | Primary |
Addresses
Primary practice location
7960 Scott Level
Baltimore, MD 21208
Mailing address
9860 Bale CT
Owings Mills, MD 21117-6386
Phone (443) 827-0876
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 |
|---|---|---|---|
| A00483 | MD | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861607384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9860 BALE CT",
"city": "OWINGS MILLS",
"state": "MD",
"postal_code": "211176386",
"telephone_number": "443-827-0876"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7960 SCOTT LEVEL",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "21208",
"telephone_number": "410-521-3600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENAFIEL",
"first_name": "JACK",
"name_prefix": "Mr.",
"credential": "OTAL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MD",
"license": "A00483",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, 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.