MEDICARE: MARIA AGOSTINA RICCOMBENI OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	.0006689	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154766111
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA AGOSTINA RICCOMBENI OTR/L

Provider Business Mailing Address
First Line	:	875 ROCK MESA PT
Second Line	:
City	:	CASTLE ROCK
State	:	CO
Zip	:	80108-7436
Country	:	US
Telephone Number	:	305-300-0473
Fax Number	:

Provider Business Practice Location Address
First Line	:	875 ROCK MESA PT
Second Line	:
City	:	CASTLE ROCK
State	:	CO
Zip	:	80108-7436
Country	:	US
Telephone Number	:	305-300-0473
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2013
Last Update Date	:	04/16/2026

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