Individual provider Active NPI

Kevin A Hardy, DPT

  • Physical Therapist
  • Chevy Chase, MD
National Provider Identifier
1063779031
Registry record updated Nov 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
24441 Issued in MD
Practice address
5454 Wisconsin Ave
Suite 600- Physical Therapy
Chevy Chase, MD 20815-6901
Phone
(301) 942-0442
NPI assigned
Apr 16, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 25490 FL
Physical Therapist 225100000X 24441 MD Primary

Addresses

Primary practice location

5454 Wisconsin Ave
Suite 600- Physical Therapy
Chevy Chase, MD 20815-6901

Mailing address

5454 Wisconsin Ave
Suite 600- Physical Therapy
Chevy Chase, MD 20815-6901
Phone (301) 942-0442

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160817000746 FL Practitioner - Physical Therapist in Private Practice 5991932857 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3903 Northdale Blvd
Suite 111W
Tampa, FL 33624-1853
Phone (813) 418-7350

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25490FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Optimal Performance and Physical Therapies Northdale LLC Physical Therapist CurrentSince Jun 1, 2016 Accepting new patients
Optimal Performance and Physical Therapies-Lutz, LLC Physical Therapist CurrentSince Aug 26, 2016 Accepting new patients

Locations

21756 State Road 54
Ste 102
Lutz, FL 33549
Phone (813) 279-6234

3903 Northdale Blvd
Ste 111W
Tampa, FL 33624
Phone (813) 381-6778

Organizations & group practices 2

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": "1334534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383868800000",
    "number": "1063779031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5454 WISCONSIN AVE",
            "address_2": "SUITE 600- PHYSICAL THERAPY",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208156901",
            "telephone_number": "301-942-0442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5454 WISCONSIN AVE",
            "address_2": "SUITE 600- PHYSICAL THERAPY",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208156901",
            "telephone_number": "301-942-0442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDY",
        "first_name": "KEVIN",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-16",
        "last_updated": "2013-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "25490",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "24441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chevy Chase, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2013; 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.