Individual provider Active NPI

Brandon Elijah Beatty

  • Physical Therapist
  • North Bethesda, MD
National Provider Identifier
1023866423
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
30325 Issued in MD
Practice address
4980 Boiling Brook Pkwy
North Bethesda, MD 20852-2300
Phone
(240) 541-5241
NPI assigned
May 9, 2024
Last updated
May 13, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physical Therapist 225100000X 30325 MD Primary

Addresses

Primary practice location

4980 Boiling Brook Pkwy
North Bethesda, MD 20852-2300

Mailing address

4704 25TH St
Mount Rainier, MD 20712-1228
Phone (301) 828-8416

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250519003639 DC Practitioner - Physical Therapist in Private Practice 9133647514 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
True Sports Physical Therapy, LLCGroup PAC ID 5496975849, 60 clinicians

Practice addresses (Care Compare)

4980 Boiling Brook Pkwy
Rockville, MD 20852-2300
Phone (240) 541-5241

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30325MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
True Sports Physical Therapy, LLC Physical Therapist CurrentSince May 1, 2025 Accepting new patients

Locations

4960 Boiling Brook Pkwy
Rockville, MD 20852
Phone (240) 261-0091

4980 Boiling Brook Pkwy
Rockville, MD 20852
Phone (240) 541-5241

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1715212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1023866423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4704 25TH ST",
            "city": "MOUNT RAINIER",
            "state": "MD",
            "postal_code": "207121228",
            "telephone_number": "301-828-8416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4980 BOILING BROOK PKWY",
            "city": "NORTH BETHESDA",
            "state": "MD",
            "postal_code": "208522300",
            "telephone_number": "240-541-5241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEATTY",
        "first_name": "BRANDON",
        "middle_name": "ELIJAH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-09",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "30325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; 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.