Individual provider Active NPI

Bdho Gidey

  • Physical Therapist
  • Washington, DC
National Provider Identifier
1134887979
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
102 Irving St NW
Washington, DC 20010-2921
Phone
(410) 823-4263
NPI assigned
Nov 29, 2021
Last updated
Aug 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary
Physical Therapist 225100000X 2305215008 VA
Physical Therapist 225100000X PT210002133 DC

Addresses

Primary practice location

102 Irving St NW
Washington, DC 20010-2921

Mailing address

1351 Otis PL NW
Washington, DC 20010-3436
Phone (202) 476-0306

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250728003676 DC Practitioner - Physical Therapist in Private Practice 3971010604 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
DC Luna Care Physical Therapy LLCGroup PAC ID 8325457468, 23 clinicians

Practice addresses (Care Compare)

1717 K St NW
Suite 900
Washington, DC 20006-5349
Phone (916) 232-3047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT210002133DCMDPhysical Therapist
2305215008VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
DC Luna Care Physical Therapy LLC Physical Therapist CurrentSince Jun 20, 2025 Accepting new patients

Locations

1717 K St NW
Ste 900
Washington, DC 20006
Phone (916) 232-3047

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1638144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1134887979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 OTIS PL NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200103436",
            "telephone_number": "202-476-0306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 IRVING ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102921",
            "telephone_number": "410-823-4263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIDEY",
        "first_name": "BDHO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-29",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305215008",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DC",
            "license": "PT210002133",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.