Active NPI
Michal Tekle
- Physical Therapist
- Laurel, MD
National Provider Identifier
1245640549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 24945
- Practice address
- 14201 Laurel Park Dr Ste 201
Laurel, MD 20707-5203 - Phone
- (301) 497-2385
- NPI assigned
- May 7, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 24945 | MD | Primary |
| Physical Therapist | 225100000X | 2305208522 | VA |
Addresses
Primary practice location
14201 Laurel Park Dr Ste 201
Laurel, MD 20707-5203
Mailing address
3812 Water Drop CT
Burtonsville, MD 20866-2043
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161114001388 | DC | Practitioner - Physical Therapist in Private Practice | 2466731591 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2305208522 | VA | MD | Physical Therapist |
Interoperability endpoints
- michaltekle@mdkml-md.direct.office.nextgen.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399420800000",
"number": "1245640549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3812 WATER DROP CT",
"city": "BURTONSVILLE",
"state": "MD",
"postal_code": "208662043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14201 LAUREL PARK DR STE 201",
"city": "LAUREL",
"state": "MD",
"postal_code": "207075203",
"telephone_number": "301-497-2385"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEKLE",
"first_name": "MICHAL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-07",
"last_updated": "2014-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "24945",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305208522",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laurel, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.