Individual provider Active NPI

Joshua Tobin Wies

  • Physical Therapist
  • Baltimore, MD
National Provider Identifier
1164877205
Registry record updated Apr 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
18331 Issued in MD
Practice address
1501 Sulgrave Ave Ste 307
Baltimore, MD 21209-3651
Phone
(410) 913-9829
NPI assigned
Apr 26, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 18331 MD Primary

Addresses

Primary practice location

1501 Sulgrave Ave Ste 307
Baltimore, MD 21209-3651

Mailing address

1501 Sulgrave Ave Ste 307
Baltimore, MD 21209-3651
Phone (410) 913-9829

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160509002209 MD Practitioner - Physical Therapist in Private Practice 1951600246 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1501 Sulgrave Ave
Suite 307
Baltimore, MD 21209-3651
Phone (410) 542-6878

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18331MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Medsy Inc Current Accepting new patients
Mount Washington Physical Therapy, LLC Physical Therapist CurrentSince Feb 25, 2016 Accepting new patients

Locations

1501 Sulgrave Ave
Ste 307
Baltimore, MD 21209
Phone (410) 542-6878

Organizations & group practices 2

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": "1461628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461628800000",
    "number": "1164877205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 SULGRAVE AVE STE 307",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212093651",
            "telephone_number": "410-913-9829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 SULGRAVE AVE STE 307",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212093651",
            "telephone_number": "410-913-9829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIES",
        "first_name": "JOSHUA",
        "middle_name": "TOBIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-26",
        "last_updated": "2016-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "18331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2016; 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.