Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Nicole Di Ponio

Individual provider Occupational Therapist · NPI 1629890686

Nicole Di Ponio is an Occupational Therapist in Private Practice in Detroit, Michigan. Qualified in 2021, 5 years ago. Practices with Life Skills Community Rehabilitation and Associates LLC, a 17-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
5
Licensed in
MI
In the registry since
2024
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Practice location Address checks out

261 Mack Ave
Detroit, MI 48201-2495
Phone: (313) 745-1203
Fax: (313) 745-0476
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 5201012693 (MI)

Record details

NPI number1629890686
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 30, 2024
Last updated in NPPESOctober 30, 2024
Certification dateOctober 29, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Life Skills Community Rehabilitation And Associates Llc — 17 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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