Individual provider Active NPI

Merob Shimeles

  • Physical Therapist
  • Olney, MD
National Provider Identifier
1306520424
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
30200 Issued in MD
Practice address
18109 Prince Philip Dr Ste 155
Olney, MD 20832-1591
Phone
(301) 260-3280
NPI assigned
Jun 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physical Therapist 225100000X 30200 MD Primary

Addresses

Primary practice location

18109 Prince Philip Dr Ste 155
Olney, MD 20832-1591

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925

Other practice location 1

711 W 40th St Ste 352
Baltimore, MD 21211-2100
Phone (410) 243-5399

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250429001751 DC Practitioner - Physical Therapist in Private Practice 9537685920 Reassigns benefits to 1 organization
I20250429001887 MD Practitioner - Physical Therapist in Private Practice 9537685920 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maryland Sportscare and Rehab LLCGroup PAC ID 2860440427, 166 clinicians

Practice addresses (Care Compare)

18221 Village Ctr Dr
Olney, MD 20832-1416
Phone (301) 798-7031

711 W 40TH St
Suite 352
Baltimore, MD 21211-2100
Phone (410) 243-5399

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland Sportscare & Rehab LLC Physical Therapist CurrentSince Apr 21, 2025 Accepting new patients
Maryland Sportscare & Rehab, LLC Physical Therapist CurrentSince Apr 21, 2025 Accepting new patients

Locations

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

711 W 40th St
Ste 352
Baltimore, MD 21211
Phone (410) 243-5399

9815 Main St
Ste 206
Damascus, MD 20872
Phone (301) 253-6761

141 Thomas Johnson Dr
Ste 180
Frederick, MD 21702
Phone (301) 620-7478

18221 Village Center Dr
Olney, MD 20832
Phone (301) 798-7031

25 Main St
Ste A
Reisterstown, MD 21136
Phone (410) 833-8300

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1686268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743638400000",
    "number": "1306520424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18109 PRINCE PHILIP DR STE 155",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321591",
            "telephone_number": "301-260-3280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "711 W 40th St Ste 352",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212112100",
            "country_code": "US",
            "telephone_number": "410-243-5399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIMELES",
        "first_name": "MEROB",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-09",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "30200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olney, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2025; 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.