Individual provider Active NPI

Gregory Keith Lemoine, PT, DPT

  • Physical Therapist
  • Rosedale, MD
National Provider Identifier
1255389169
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
20651 Issued in MD
Practice address
1232 Race Rd Ste 203
Rosedale, MD 21237-2376
Phone
(410) 918-0080
Fax
(410) 918-0050
NPI assigned
May 4, 2006
Last updated
Sep 27, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 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 20651 MD Primary

Addresses

Primary practice location

1232 Race Rd Ste 203
Rosedale, MD 21237-2376

Mailing address

1232 Race Rd Ste 203
Rosedale, MD 21237-2376
Phone (410) 918-0080

Other practice location 1

6615 Reisterstown Rd Ste 300
Baltimore, MD 21215-2689
Phone (443) 627-8921

Other identifiers 2

IdentifierTypeStateIssuer
LV17OtherMDCAREFIRST BLUECROSS/SHIEL
E705-0004OtherMDFEDERAL BLUECROSS/SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070817000177 MD Practitioner - Physical Therapist in Private Practice 5991897191 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Maryland School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1232 Race Rd
Suite 203
Baltimore, MD 21237-2376
Phone (410) 918-0080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20651MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lemoine & Associates Physical Therapy, Inc Physical Therapist CurrentSince Feb 5, 2011 Accepting new patients
Lemoine & Associates Physical Therapy, Inc Physical Therapist CurrentSince Oct 24, 2021 Accepting new patients
Lemoine & Associates Physical Therapy LLC Physical Therapist PastSince Sep 1, 2007 Accepting new patients

Locations

6615 Reisterstown Rd
Ste 300
Baltimore, MD 21215
Phone (443) 627-8921

1232 Race Rd
Ste 203
Rosedale, MD 21237
Phone (410) 780-1980

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, 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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1255389169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1232 RACE RD STE 203",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "212372376",
            "telephone_number": "410-918-0080",
            "fax_number": "410-918-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1232 RACE RD STE 203",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "212372376",
            "telephone_number": "410-918-0080",
            "fax_number": "410-918-0050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6615 Reisterstown Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212152689",
            "country_code": "US",
            "telephone_number": "443-627-8921",
            "fax_number": "410-918-0050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEMOINE",
        "first_name": "GREGORY",
        "middle_name": "KEITH",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "20651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BLUECROSS/SHIEL",
            "identifier": "LV17",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLUECROSS/SHIELD",
            "identifier": "E705-0004",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosedale, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.