Individual provider Active NPI

Michael Stangroom, DPT

  • Physical Therapist
  • Bel Air, MD
National Provider Identifier
1184118713
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
2021A Emmorton Rd Ste 110
Bel Air, MD 21015-8914
Phone
(410) 515-0006
Fax
(410) 515-0027
NPI assigned
Jun 18, 2018
Last updated
Apr 1, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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 2305211989 VA
Physical Therapist 225100000X MD Primary

Addresses

Primary practice location

2021A Emmorton Rd Ste 110
Bel Air, MD 21015-8914

Mailing address

2001 Butterfield Rd Ste 1600
Downers Grove, IL 60515-1211

Other practice location 1

BLANCHFIELD Army Community Hospital
Fort Campbell, KY 42223
Phone (270) 798-8953

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250408003593 MD Practitioner - Physical Therapist in Private Practice 8527582865 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ati Holdings, LLCGroup PAC ID 9537112719, 440 clinicians

Practice addresses (Care Compare)

2021 -A Emmorton Rd
110 Ati Physical Therapy
Bel Air, MD 21015-8914
Phone (410) 515-0006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30330MDMDSocial Worker
2305211989VAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings, LLC Physical Therapist CurrentSince Mar 31, 2025 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Mar 31, 2025 Accepting new patients

Locations

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

2001 Butterfield Rd
Ste 1600
Downers Grove, IL 60515

2021A Emmorton Rd
Ste 110
Bel Air, MD 21015
Phone (410) 515-0006

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

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

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, 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": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1184118713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021A EMMORTON RD STE 110",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210158914",
            "telephone_number": "410-515-0006",
            "fax_number": "410-515-0027"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "BLANCHFIELD Army Community Hospital",
            "address_purpose": "LOCATION",
            "city": "Fort Campbell",
            "state": "KY",
            "postal_code": "42223",
            "country_code": "US",
            "telephone_number": "270-798-8953",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANGROOM",
        "first_name": "MICHAEL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-18",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "VA",
            "license": "2305211989",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2025; 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.