Individual provider Active NPI

Ryan Bibeau, DPT, CSCS

  • Physical Therapist
  • Columbia, MD
National Provider Identifier
1013608892
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
8895 McGaw Rd Ste G
Columbia, MD 21045-4746
Phone
(443) 441-0616
NPI assigned
May 15, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

8895 McGaw Rd Ste G
Columbia, MD 21045-4746

Mailing address

1701 Matisse CT
Severn, MD 21144-1632
Phone (410) 903-2004

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231020000532 MD Practitioner - Physical Therapist in Private Practice 4789030263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

133 Defense Hwy
Annapolis, MD 21401-7015

8895 McGaw Rd
Suite G
Columbia, MD 21045-4746
Phone (443) 441-0616

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29573MDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Aug 1, 2023 Accepting new patients
Privia Medical Group, LLC CurrentSince Aug 1, 2023 Accepting new patients
Nova Physician Wellness Center PLLC Past Accepting new patients

Locations

133 Defense Hwy
Ste 112
Annapolis, MD 21401
Phone (410) 573-0140

8895 McGaw Rd
Ste G
Columbia, MD 21045
Phone (443) 441-0616

9159 Red Branch Rd
Ste F
Columbia, MD 21045
Phone (301) 887-5689

11350 Pembrooke Sq
Ste 304
Waldorf, MD 20603
Phone (301) 856-2810

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: ryan.bibeau.1@8042.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1013608892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 MATISSE CT",
            "city": "SEVERN",
            "state": "MD",
            "postal_code": "211441632",
            "telephone_number": "410-903-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8895 MCGAW RD STE G",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210454746",
            "telephone_number": "443-441-0616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIBEAU",
        "first_name": "RYAN",
        "credential": "DPT, CSCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; 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.