Kodiak Physiatry Consulting
Organization Active NPI Physical Medicine & Rehabilitation Physician · Boonsboro, MD
NPI 1235945700 · NPPES record last updated Jan 27, 2025
Key facts
- NPI
- 1235945700
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Medicine & Rehabilitation Physician 208100000X
- Legal business name
- KODIAK PHYSIATRY CONSULTING
- Practice address
- 141 S Main St
Boonsboro, MD 21713-1203 - Phone
- (301) 432-5457
- NPI assigned
- Dec 9, 2024
- Organization subpart
- No
Authorized official
- Name
- Dr. Bilaal A Saif, DO
- Title
- Owner
- Phone
- (240) 291-0197
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250129001161 | PA | Part B Supplier - Clinic/Group Practice | 6002345501 |
Receives reassigned benefits from 1 practitioner Practice locations: York, PA |
National Provider Directory
Locations
5 Public Sq
#301604
Hagerstown, MD 21740
5 Public Sq
Ste 301604
Hagerstown, MD 21740
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician |
208100000X | Yes |
Addresses
Primary practice location
141 S Main St
Boonsboro, MD 21713-1203
Mailing address
5 Public SQ St 301
#604
Hagerstown, MD 21740
Phone (240) 291-0197
Other providers in Boonsboro, MD
- Shabbar Hussain
- Integrated Rehab Consultants LLC
- Jack E. Barr Center for Well-Being
- Sally Jornlin
- Kathryn Brooke Kindler
- Chelsea Rose Ksanznak
- Neelam Lakade
- Michael Brian Lapole
- Heather Leasure
- Melissa Marie Leplatt
All providers in Boonsboro, MD · Physical Medicine & Rehabilitation Physician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.