Individual provider Active NPI

Mary Patrice Forbes, PT

  • Physical Therapist
  • Dundalk, MD
National Provider Identifier
1245326073
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05002275A Issued in IN
Practice address
1401 Merritt Blvd Ste D
Dundalk, MD 21222-2140
Phone
(443) 530-9750
NPI assigned
Oct 5, 2006
Last updated
Oct 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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 05002275A IN Primary

Addresses

Primary practice location

1401 Merritt Blvd Ste D
Dundalk, MD 21222-2140

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223

Other practice location 1

822 N Baldwin Ave
Marion, IN 46952-2542
Phone (765) 733-1127

Other identifiers 1

IdentifierTypeStateIssuer
200429730MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140507000607 IN Practitioner - Physical Therapist in Private Practice 3375776891 Reassigns benefits to 1 organization
I20241017004477 MD Practitioner - Physical Therapist in Private Practice 3375776891 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1987
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)

7624 Belair Rd
Baltimore, MD 21236-4088
Phone (667) 219-2169

Merit-based Incentive Payment System (MIPS)

Final score
85.3 of 100Reported as group
Quality
88.48
Improvement activities
40
Cost
72.11

Merit-based Incentive Payment System (MIPS)

Final score
86.05 of 100Reported as group
Quality
89.12
Improvement activities
40
Cost
73.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30148MDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Physical Therapy, LLC Physical Therapist CurrentSince Apr 30, 2014 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Nov 1, 2024 Accepting new patients
Advanced Physical Therapy, LLC Physical Therapist CurrentSince Apr 30, 2014 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Nov 1, 2024 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

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

11681 Brooks School Rd
Ste 1
Fishers, IN 46037
Phone (317) 813-0148

1818 N State St
Greenfield, IN 46140
Phone (317) 462-1800

433 N Capitol Ave
Ste 102
Indianapolis, IN 46204
Phone (317) 860-1646

4950 E Stop 11 Rd
Ste B
Indianapolis, IN 46237
Phone (317) 859-5857

5450 E Fall Creek Parkway North Dr
Ste 102
Indianapolis, IN 46226
Phone (317) 352-5591

5949 W Raymond St
Indianapolis, IN 46241
Phone (317) 247-1579

7914 N Shadeland Ave
Ste 100
Indianapolis, IN 46250
Phone (317) 579-0797

822 N Baldwin Ave
Marion, IN 46952
Phone (765) 733-1127

3300 N Morrison Rd
Muncie, IN 47304
Phone (765) 587-7105

7624 Belair Rd
Baltimore, MD 21236
Phone (667) 219-2169

1401 Merritt Blvd
Ste D
Dundalk, MD 21222
Phone (443) 530-9750

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 4

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1245326073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 MERRITT BLVD STE D",
            "city": "DUNDALK",
            "state": "MD",
            "postal_code": "212222140",
            "telephone_number": "443-530-9750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "822 N Baldwin Ave",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "IN",
            "postal_code": "469522542",
            "country_code": "US",
            "telephone_number": "765-733-1127",
            "fax_number": "765-733-1128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORBES",
        "first_name": "MARY",
        "middle_name": "PATRICE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05002275A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200429730",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dundalk, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; 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.