Michelle Renee Teodoro, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT4758 Issued in ME

Practice address

26 State St Apt 1
Portland, ME 04101-3706

Phone

(215) 908-1146

NPI assigned

Oct 23, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1729641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1992526743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 STATE ST APT 1",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041013706",
            "telephone_number": "215-908-1146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 STATE ST APT 1",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041013706",
            "telephone_number": "215-908-1146"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "275 E High St Apt H146",
            "address_purpose": "LOCATION",
            "city": "Glassboro",
            "state": "NJ",
            "postal_code": "080282344",
            "country_code": "US",
            "telephone_number": "215-908-1146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEODORO",
        "first_name": "MICHELLE",
        "middle_name": "RENEE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-23",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ME",
            "license": "OT4758",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR01201700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evelyne Tchokochoua
• Laurel C Tegtman, LMSW-CC
• Alia Teja, MBCHB
• Stephen Telow
• Laura Tennenhouse, CLCPC
• Hilary Dianne Terhune, PT
• Jill M Terranova, CRNA
• David P Terwilliger, PA
• Devin Shaughnessy Tetler, AGPCNP-BC
• Alison Moore Tetrault, PMHNP-BC

• Occupational Therapist in Portland, ME
• Providers in Portland, ME by specialty
• Occupational Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.