Individual provider Active NPI

Eric M. Cohen, PT

  • Physical Therapist
  • Bowie, MD
National Provider Identifier
1205059466
Registry record updated Aug 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
14797 Issued in MD
Practice address
4367 Northview Drive
Bowie, MD 20716
Phone
(301) 464-4500
Fax
(301) 464-8818
NPI assigned
Apr 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2021

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 14797 MD Primary

Addresses

Primary practice location

4367 Northview Drive
Bowie, MD 20716

Mailing address

4367 Northview Drive
Bowie, MD 20716
Phone (301) 464-4500

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040902000223 DC Practitioner - Physical Therapist in Private Practice 8628043502 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1221 Mercantile LN
Largo, MD 20774-5374
Phone (301) 618-5700

4400 Forbes Blvd
Lanham, MD 20706-4447
Phone (301) 341-3882

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14797MDMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 9, 2013 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 9, 2013 Accepting new patients
Professional Sportscare & Rehab, LLC Physical Therapist Past Accepting new patients

Locations

2101 E Jefferson St
Ste 6
Rockville, MD 20852

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

Organizations & group practices 3

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": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1205059466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4367 NORTHVIEW DRIVE",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "20716",
            "telephone_number": "301-464-4500",
            "fax_number": "301-464-8818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4367 NORTHVIEW DRIVE",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "20716",
            "telephone_number": "301-464-4500",
            "fax_number": "301-464-8818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "ERIC",
        "middle_name": "M.",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "14797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4367 Northview Drive",
            "city": "Bowie",
            "state": "MD",
            "country_code": "US",
            "postal_code": "20716",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2021; 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.