Active NPI
Edwin Gabriel Tello Salas
- Physical Therapist
- Falls Church, VA
National Provider Identifier
1124858212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 5663 Columbia Pike
Falls Church, VA 22041-2868 - Phone
- (703) 671-1871
- NPI assigned
- Aug 5, 2024
- Sex
- Male
- 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 | Primary |
Addresses
Primary practice location
5663 Columbia Pike
Falls Church, VA 22041-2868
Mailing address
25543 Feltre Ter
Chantilly, VA 20152-6100
Phone (571) 502-3845
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5663 Columbia Pike
Falls Church, VA 22041-2868
Phone (703) 671-1871
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Respire Physical Therapy LLC | Physical Therapist | Current | Accepting new patients |
Locations
5017D Backlick Rd
Annandale, VA 22003
Phone (571) 369-6728
5663 Columbia Pike
Falls Church, VA 22041
Phone (703) 671-1871
Organizations & group practices 1
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": "1722816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722816000000",
"number": "1124858212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25543 FELTRE TER",
"city": "CHANTILLY",
"state": "VA",
"postal_code": "201526100",
"telephone_number": "571-502-3845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5663 COLUMBIA PIKE",
"city": "FALLS CHURCH",
"state": "VA",
"postal_code": "220412868",
"telephone_number": "703-671-1871"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TELLO SALAS",
"first_name": "EDWIN",
"middle_name": "GABRIEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-08-05",
"last_updated": "2024-08-05",
"certification_date": "2024-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Falls Church, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.