Active NPI
Mdics Rehabilitative Services LLC
- Internal Medicine Physician
- Glen Burnie, MD
National Provider Identifier
1124313309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- MDICS REHABILITATIVE SERVICES LLC
- Practice address
- 6934 Aviation Blvd
Suite B
Glen Burnie, MD 21061-2593 - Phone
- (443) 949-0814
- Fax
- (443) 949-0825
- NPI assigned
- Jun 15, 2011
- Last updated
- Jan 12, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tim Delbrugge
- Title
- Cfo
- Phone
- (301) 693-8707
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | |||
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
6934 Aviation Blvd
Suite B
Glen Burnie, MD 21061-2593
Mailing address
PO Box 69231
Baltimore, MD 21264-9231
Phone (443) 949-0814
Other practice location 1
1000 N Gilmor St
Baltimore, MD 21217-2207
Phone (410) 669-2750
Other practice location 2
531 Stevenson Ln
Towson, MD 21286-7607
Phone (410) 823-5310
Other practice location 3
2700 Southaven Rd
Annapolis, MD 21401-7122
Phone (410) 897-1300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, MD
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120202000749 | DC | Part B Supplier - Clinic/Group Practice | 4981861903 |
Receives reassigned benefits from 158 practitioners Practice locations: Silver Spring, MD; Takoma Park, MD; Clinton, MD; Mitchellville, MD; Kensington, MD; Sandy Spring, MD |
| O20120206000334 | MD | Part B Supplier - Clinic/Group Practice | 4981861903 |
Receives reassigned benefits from 71 practitioners 1 other NPI on this enrollment Practice locations: Pikesville, MD; Glen Burnie, MD; Hagerstown, MD; La Plata, MD; Leonardtown, MD; Lexington Park, MD; Prince Frederick, MD; Randallstown, MD… |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryLocations
121 Morris Dr
La Plata, MD 20646
Phone (410) 999-1133
154 N Artizan St
Williamsport, MD 21795
Phone (301) 223-6301
Practitioners & affiliated clinicians
Practitioners 162
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.
-
- Family Nurse Practitioner
- Mount Airy, MD
- NPI 1144734492
DC, Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308096000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1705017600000",
"number": "1124313309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 69231",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212649231",
"telephone_number": "443-949-0814",
"fax_number": "443-949-0825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6934 AVIATION BLVD",
"address_2": "SUITE B",
"city": "GLEN BURNIE",
"state": "MD",
"postal_code": "210612593",
"telephone_number": "443-949-0814",
"fax_number": "443-949-0825"
}
],
"practiceLocations": [
{
"address_1": "1000 N Gilmor St",
"address_purpose": "LOCATION",
"city": "Baltimore",
"state": "MD",
"postal_code": "212172207",
"country_code": "US",
"telephone_number": "410-669-2750",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "531 Stevenson Ln",
"address_purpose": "LOCATION",
"city": "Towson",
"state": "MD",
"postal_code": "212867607",
"country_code": "US",
"telephone_number": "410-823-5310",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2700 Southaven Rd",
"address_purpose": "LOCATION",
"city": "Annapolis",
"state": "MD",
"postal_code": "214017122",
"country_code": "US",
"telephone_number": "410-897-1300",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "MDICS REHABILITATIVE SERVICES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2011-06-15",
"last_updated": "2024-01-12",
"certification_date": "2024-01-12",
"status": "A",
"authorized_official_last_name": "DELBRUGGE",
"authorized_official_first_name": "TIM",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "301-693-8707"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glen Burnie, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.