NPIMap

Organization Active NPI

Sparks Physical Therapy, Inc.

  • Multi-Specialty Clinic/Center
  • Sparks Glencoe, MD
National Provider Identifier
1033738687
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
SPARKS PHYSICAL THERAPY, INC.
Practice address
954 Ridgebrook Rd Ste 310-330
Sparks Glencoe, MD 21152-9468
Phone
(443) 212-5745
Fax
(443) 212-5749
NPI assigned
Apr 14, 2020
Last updated
Nov 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Authorized official

Name
Irina Mercedes Figueroa-Velez
Title
Office Manager
Phone
(443) 212-5745

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Occupational Therapist 225X00000X
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

954 Ridgebrook Rd Ste 310-330
Sparks Glencoe, MD 21152-9468

Mailing address

954 Ridgebrook Rd Ste 310
Sparks Glencoe, MD 21152-9440
Phone (443) 212-5745

Other identifiers 1

IdentifierTypeStateIssuer
666629900MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200707003237 MD Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9537582689 Receives reassigned benefits from 12 practitioners
Practice locations: Sparks Glencoe, MD

National Provider Directory

National Provider Directory
Tax ID family
Sparks Physical Therapy Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

954 Ridgebrook Rd
Ste 310
Sparks Glencoe, MD 21152
Phone (443) 212-5745

954 Ridgebrook Rd
Ste 310330
Sparks Glencoe, MD 21152
Phone (443) 212-5745

954 Ridgebrook Rd
Ste 330
Sparks Glencoe, MD 21152
Phone (301) 792-1450

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1586822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730764800000",
    "number": "1033738687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "954 RIDGEBROOK RD STE 310",
            "city": "SPARKS GLENCOE",
            "state": "MD",
            "postal_code": "211529440",
            "telephone_number": "443-212-5745",
            "fax_number": "443-212-5749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "954 RIDGEBROOK RD STE 310-330",
            "city": "SPARKS GLENCOE",
            "state": "MD",
            "postal_code": "211529468",
            "telephone_number": "443-212-5745",
            "fax_number": "443-212-5749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARKS PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-14",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A",
        "authorized_official_last_name": "FIGUEROA-VELEZ",
        "authorized_official_first_name": "IRINA",
        "authorized_official_middle_name": "MERCEDES",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "443-212-5745"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "666629900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparks Glencoe, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.