NPIMap

Individual provider Active NPI

Sandra Bynaker, PT

  • Physical Therapist
  • Waldorf, MD
National Provider Identifier
1215607684
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
28667 Issued in MD
Practice address
3320 Crain Hwy
Waldorf, MD 20603-4850
Phone
(301) 870-7366
Fax
(301) 870-6717
NPI assigned
Sep 17, 2021
Last updated
Sep 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305214642 VA
Physical Therapist 225100000X 28667 MD Primary

Addresses

Primary practice location

3320 Crain Hwy
Waldorf, MD 20603-4850

Mailing address

PO Box 791217
Baltimore, MD 21279-1217
Phone (301) 932-4785

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28667MDMDClinical Social Worker
2305214642VAMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1631836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1215607684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 791217",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212791217",
            "telephone_number": "301-932-4785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 CRAIN HWY",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034850",
            "telephone_number": "301-870-7366",
            "fax_number": "301-870-6717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYNAKER",
        "first_name": "SANDRA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-17",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305214642",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "28667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.