Michael Datiles, DPT
Individual provider Active NPI Physical Therapist · Forestville, MD
NPI 1154096766 · NPPES record last updated Nov 5, 2025
Key facts
- NPI
- 1154096766
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 30647 (MD)
- Practice address
- 2950 Donnell Dr Ste G
Forestville, MD 20747-3277 - Phone
- (240) 492-3410
- NPI assigned
- Aug 16, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 11
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ati Holdings, LLC
Practice addresses (Care Compare)
2950 Donnell Dr
Suite G
Forestville, MD 20747-3277
Phone (240) 492-3410
435 E Ridgeville Blvd
Ati Physical Therapy
Mount Airy, MD 21771-5217
Phone (240) 732-2334
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in DC, MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251212000889 | DC | Practitioner - Physical Therapist in Private Practice | 4284128653 | Reassigns benefits to 1 organization |
| I20260511001678 | MD | Practitioner - Physical Therapist in Private Practice | 4284128653 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30647 | MD | MD | Clinical Social Worker |
| 2305214541 | VA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ati Holdings, LLC | Physical Therapist | Current |
Accepting new patients |
| Ati Holdings, LLC | Physical Therapist | Current |
Accepting new patients |
Locations
4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001
2001 Butterfield Rd
Ste 1600
Downers Grove, IL 60515
2950 Donnell Dr
Ste G
Forestville, MD 20747
Phone (240) 492-3410
435 E Ridgeville Blvd
Mount Airy, MD 21771
Phone (240) 732-2334
11271 New Hampshire Ave
Silver Spring, MD 20904
Phone (240) 485-1280
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2305214541 | VA | |
| Physical Therapist | 225100000X | 30647 | MD | Yes |
Addresses
Primary practice location
2950 Donnell Dr Ste G
Forestville, MD 20747-3277
Mailing address
2001 Butterfield Rd Ste 1600
Downers Grove, IL 60515-1211
Phone (866) 370-8206
Other practice location 1
8501 Arlington Blvd Ste 200
Fairfax, VA 22031-4625
Phone (703) 970-6490
Other providers in Forestville, MD
- Clean and Sober
- Robert Preston Cohen
- Lauren Hallie Collins
- Lucretia Cunningham
- Claudia Darden
- Reynaldo De la Cruz Jr.
- Rabia Dhanani
- Dimensions Wellness II LLC
- DNR Carenet LLC
- Brittany Dorsey-Rawlings
All providers in Forestville, MD · Physical Therapist in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 5, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.