Jennifer M Pelleg, DPT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

25802 Issued in MD

Practice address

11085 Little Patuxent Pkwy Ste 207
Columbia, MD 21044-2979

Phone

(410) 884-4111

NPI assigned

Jul 12, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Jennifer M Breithaupt Former name

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

May accept Medicare assignment

Group practices

Performance Physical Therapy and Sports Rehabilitation, LLCGroup PAC ID 0648535526, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Performance Physical Therapy and Sports Rehabilitation LLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Columbia, MD
  • NPI 1003313966

  Orthopedic

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1342051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1275898421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5715 OLD BUGGY CT",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452513",
            "telephone_number": "610-952-8961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11085 LITTLE PATUXENT PKWY STE 207",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210442979",
            "telephone_number": "410-884-4111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9160 Rumsey Rd Ste B4",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MD",
            "postal_code": "210452034",
            "country_code": "US",
            "telephone_number": "410-381-1574",
            "fax_number": "410-381-5174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PELLEG",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-12",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "PA",
            "license": "PT022075",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MD",
            "license": "25802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BREITHAUPT",
            "middle_name": "M",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Danielle Peay
• Helen Mary Pechacek, CRNP
• Regina Ann Peck
• Pediatrix Medical Group of the Mid-Atlantic PC
• Marta Almeida Pedro, MSW, LCSW
• Barry Peltzman, DDS
• Pelvic Gynecology Associates of Baltimore PC
• Ann Louise Pemberton, LCSW-C
• Ashley Pempek
• Denise Pena

• Orthopedic Physical Therapist in Columbia, MD
• Providers in Columbia, MD by specialty
• Orthopedic Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.