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Integrated Rehab Consultants LLC

Organization Active NPI Physical Medicine & Rehabilitation Physician · Lutherville Timonium, MD

NPI 1104643022 · NPPES record last updated Sep 23, 2024

Key facts

NPI
1104643022
Entity type
Organization (NPI type 2)
Primary specialty
Physical Medicine & Rehabilitation Physician 208100000X
Legal business name
INTEGRATED REHAB CONSULTANTS LLC
Practice address
12230 Roundwood Rd
Lutherville Timonium, MD 21093-3233
Phone
(312) 635-0973
Fax
(312) 635-0050
NPI assigned
Sep 23, 2024
Organization subpart
Yes
Parent organization (as reported)
INTEGRATED REHAB CONSULTANTS LLC

Authorized official

Name
Amish Manu Patel NPI 1457502619
Title
Ceo
Phone
(312) 635-0973

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Other NPIs on the same Medicare enrollment 19

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 31

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

View all 31

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MD

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20140729001537 MD Part B Supplier - Clinic/Group Practice 7810184892 Receives reassigned benefits from 9 practitioners
19 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

National Provider Directory

Tax ID family
Jonesboro Nursing Rehab (32 organizations share this tax ID)
Part of
Jonesboro Nursing Rehab

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 208100000X Yes

Addresses

Primary practice location

12230 Roundwood Rd
Lutherville Timonium, MD 21093-3233

Mailing address

PO Box 74008272
Chicago, IL 60674-8272
Phone (312) 635-0973

Other providers in Lutherville Timonium, MD

All providers in Lutherville Timonium, MD · Physical Medicine & Rehabilitation Physician in Maryland

Sources for this page

Verify at the official NPI Registry.