Active NPI
Samantha San Juan
- Physical Therapist
- Hyattsville, MD
National Provider Identifier
1063825040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 24277
- Practice address
- 4922 Lasalle Rd
Hyattsville, MD 20782-3302 - Phone
- (301) 864-2333
- NPI assigned
- Jun 6, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 24277 | MD | Primary |
Addresses
Primary practice location
4922 Lasalle Rd
Hyattsville, MD 20782-3302
Mailing address
3871 Chain Bridge Rd
Fairfax, VA 22030-3903
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402012800000",
"number": "1063825040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3871 CHAIN BRIDGE RD",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220303903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4922 LASALLE RD",
"city": "HYATTSVILLE",
"state": "MD",
"postal_code": "207823302",
"telephone_number": "301-864-2333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAN JUAN",
"first_name": "SAMANTHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-06",
"last_updated": "2014-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "24277",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hyattsville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.