Individual provider Active NPI

Jyoti Panchal, DPT

  • Physical Therapist
  • Baltimore, MD
National Provider Identifier
1164984837
Registry record updated Jul 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
27393 Issued in MD
Practice address
809 N Charles St Ste 201
Baltimore, MD 21201-5307
Phone
(410) 837-4171
NPI assigned
Apr 2, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 27393 MD
Physical Therapist 225100000X 27393 MD Primary

Addresses

Primary practice location

809 N Charles St Ste 201
Baltimore, MD 21201-5307

Mailing address

PO Box 419666
Boston, MA 02241-9666
Phone (410) 970-8190

Other practice location 1

12150 Annapolis Rd
Glenn Dale, MD 20769-9183
Phone (301) 352-8370

Other practice location 2

192 Halpine Rd Ste D
Rockville, MD 20852-7645
Phone (240) 514-2400

Other practice location 3

7021 Martin Luther King Jr Hwy
Landover, MD 20785
Phone (301) 341-4600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC, NJ3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20190610000211 MD Practitioner - Physical Therapist in Private Practice 0547593469 Reassigns benefits to 2 organizations
I20190610000329 DC Practitioner - Physical Therapist in Private Practice 0547593469 Reassigns benefits to 2 organizations
I20220713003208 NJ Practitioner - Physical Therapist in Private Practice 0547593469

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

818 W Diamond Ave
Suite 110
Gaithersburg, MD 20878-1450
Phone (301) 388-5960

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27393MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings, LLC Physical Therapist CurrentSince Jun 1, 2019 Accepting new patients
Forever Fit Physical Therapy & Wellness Physical Therapist CurrentSince Sep 18, 2023 Accepting new patients
Forever Fit Physical Therapy & Wellness, LLC CurrentSince Sep 18, 2023 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Jun 1, 2019 Accepting new patients
Active Physical Therapy Services, LLC Physical Therapist PastSince Jul 1, 2020 Accepting new patients
Maryland Spine Rehab, LLC PastSince Jul 1, 2020 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

4740 Cherry Hill Rd
College Park, MD 20740
Phone (240) 965-0999

9 Lee Airpark Dr
Ste 400
Edgewater, MD 21037
Phone (443) 607-1469

1510 Rock Spring Rd
Ste C
Forest Hill, MD 21050
Phone (410) 420-3619

818 W Diamond Ave
Ste 110
Gaithersburg, MD 20878
Phone (301) 388-5960

52 Rising Sun Town Ctr
Rising Sun, MD 21911
Phone (410) 658-0100

192 Halpine Rd
Ste D
Rockville, MD 20852
Phone (240) 514-2400

15850 Crabbs Branch Way
Ste 120
Rockville, MD 20855
Phone (301) 388-5960

11271 New Hampshire Ave
Silver Spring, MD 20904
Phone (240) 485-1280

10301 Georgia Ave
Ste 200
Silver Spring, MD 20902
Phone (301) 593-7300

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DIEEAA

Organizations & group practices 6

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": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1164984837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 419666",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022419666",
            "telephone_number": "410-970-8190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 N CHARLES ST STE 201",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212015307",
            "telephone_number": "410-837-4171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12150 Annapolis Rd",
            "address_purpose": "LOCATION",
            "city": "Glenn Dale",
            "state": "MD",
            "postal_code": "207699183",
            "country_code": "US",
            "telephone_number": "301-352-8370",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "192 Halpine Rd Ste D",
            "address_purpose": "LOCATION",
            "city": "Rockville",
            "state": "MD",
            "postal_code": "208527645",
            "country_code": "US",
            "telephone_number": "240-514-2400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7021 Martin Luther King Jr Hwy",
            "address_purpose": "LOCATION",
            "city": "Landover",
            "state": "MD",
            "postal_code": "20785",
            "country_code": "US",
            "telephone_number": "301-341-4600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANCHAL",
        "first_name": "JYOTI",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-02",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MD",
            "license": "27393",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "27393",
            "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 Jul 31, 2020; 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.