Individual provider Active NPI

Hannah Marie Vaca, DPT

  • Physical Therapist
  • Nottingham, MD
National Provider Identifier
1073239570
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
29933 Issued in MD
Practice address
4924 Campbell Blvd
Nottingham, MD 21236-5908
Phone
(410) 955-5000
NPI assigned
Oct 17, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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 2587 SD
Physical Therapist 225100000X 29933 MD Primary

Addresses

Primary practice location

4924 Campbell Blvd
Nottingham, MD 21236-5908

Mailing address

6201 Greenleigh Ave
Middle River, MD 21220-2004
Phone (605) 582-3908

Other practice location 1

103 N Splitrock Blvd
Brandon, SD 57005-1529
Phone (605) 582-3908

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221130002452 SD Practitioner - Physical Therapist in Private Practice 7719355486 Reassigns benefits to 1 organization
I20241231003350 MD Practitioner - Physical Therapist in Private Practice 7719355486 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1000 E Eager St
E Baltimore Med Ctr
Baltimore, MD 21202-5533
Phone (410) 522-9800

4924 Campbell Blvd
Suite 130a
Nottingham, MD 21236-5909
Phone (443) 442-2800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29933MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins Community Physicians, Inc. CurrentSince Dec 1, 2024 Accepting new patients
Johns Hopkins Community Physicians, Inc Current Accepting new patients
Johns Hopkins Community Physicians CurrentSince Dec 1, 2024 Accepting new patients
Avera McKennan Physical Therapist CurrentSince Oct 5, 2022 Accepting new patients
Avera McKennan CurrentSince Oct 5, 2022 Accepting new patients
Avera McKennan Current Accepting new patients

Locations

1000 E Eager St
Baltimore, MD 21202
Phone (410) 522-9800

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

4924 Campbell Blvd
Nottingham, MD 21236
Phone (443) 442-2200

103 N Splitrock Blvd
Brandon, SD 57005
Phone (605) 582-3908

300 W 5th St
Miller, SD 57362
Phone (605) 853-0158

Organizations & group practices 6

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": "1665964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1073239570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004",
            "telephone_number": "605-582-3908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4924 CAMPBELL BLVD",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212365908",
            "telephone_number": "410-955-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 N Splitrock Blvd",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "SD",
            "postal_code": "570051529",
            "country_code": "US",
            "telephone_number": "605-582-3908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VACA",
        "first_name": "HANNAH",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-17",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SD",
            "license": "2587",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "29933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nottingham, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.