Maxwell Blake

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305212147 Issued in VA

Practice address

1600 Wilson Blvd Ste 102
Arlington, VA 22209-2505

Phone

(703) 935-1996

Fax

(703) 935-1995

NPI assigned

Aug 8, 2018

Last updated

Aug 8, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, VA2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

University of Vermont College of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Professional Sportscare and Rehab LLCGroup PAC ID 9335137363, 103 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.48 of 100Reported as group

Quality

86.04

Promoting interoperability

99

Improvement activities

40

Cost

76.38

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Professional Sportscare & Rehab, LLC

  dba Pivot Physical Therapy of Metro DC

  • Clinic/Center
  • Winchester, VA
  • NPI 1033142294

  DC, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Tidewater Physical Therapy, LLC

  dba Pivot Physical Therapy of Virginia

  • Physical Therapist
  • Glen Allen, VA
  • NPI 1457389595

  DC

  Medicare reassignment

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1023597382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 NEW FIDELITY CT",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275292665",
            "telephone_number": "919-258-2714",
            "fax_number": "410-648-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 WILSON BLVD STE 102",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222092505",
            "telephone_number": "703-935-1996",
            "fax_number": "703-935-1995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "MAXWELL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-08",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305212147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydney Lauren Blackman, SLP-CFY
• Carly B Blackstone, PSY.D.
• Guido Blacutt
• Thomas Blahovec, P.T.
• Martelle Blaine, PA-C
• Jacqueline Angelica Blakely
• Norma Blann, RPH
• Chandreea K Blanton
• Natalie Block-Levin, LCSW
• Bloom Dental, PLLC

• Physical Therapist in Arlington, VA
• Providers in Arlington, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2018; 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.