Organization Active NPI

Ace Physical Therapy & Sports Medicine Institute, LLC

  • Physical Therapist
  • Great Falls, VA
National Provider Identifier
1003368663
Registry record updated Oct 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ACE PHYSICAL THERAPY & SPORTS MEDICINE INSTITUTE, LLC
Practice address
10123 Colvin Run Rd
Great Falls, VA 22066-1873
Phone
(703) 205-1233
NPI assigned
Oct 31, 2016
Last updated
Oct 31, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2016

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

Authorized official

Name
Michael Ercole, MSPT
Title
Institute Director
Phone
(703) 205-1233

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X VA Primary

Addresses

Primary practice location

10123 Colvin Run Rd
Great Falls, VA 22066-1873

Mailing address

2841 Hartland Rd Ste 401B
Falls Church, VA 22043-3500
Phone (703) 205-1233

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070301000072 DC Part B Supplier - Clinic/Group Practice 3173625787 Receives reassigned benefits from 12 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Herndon, VA; Vienna, VA; Falls Church, VA; Arlington, VA; Alexandria, VA; Fairfax, VA

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1477872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477872000000",
    "number": "1003368663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2841 HARTLAND RD STE 401B",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220433500",
            "telephone_number": "703-205-1233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10123 COLVIN RUN RD",
            "city": "GREAT FALLS",
            "state": "VA",
            "postal_code": "220661873",
            "telephone_number": "703-205-1233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACE PHYSICAL THERAPY & SPORTS MEDICINE INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-31",
        "last_updated": "2016-10-31",
        "status": "A",
        "authorized_official_last_name": "ERCOLE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "INSTITUTE DIRECTOR",
        "authorized_official_telephone_number": "703-205-1233",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Falls, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.