Individual provider Active NPI

Adwoa K Bonsra Boadi, PT

  • Orthopedic Physical Therapist
  • Baltimore, MD
National Provider Identifier
1336260413
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
21987 Issued in MD
Practice address
7672 Belair Rd
Baltimore, MD 21236-4088
Phone
(410) 663-6450
Fax
(410) 663-6451
NPI assigned
Apr 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical Therapist 2251S0007X 21987 MD
Orthopedic Physical Therapist 2251X0800X 21987 MD Primary
Physical Therapist 225100000X 21987 MD

Addresses

Primary practice location

7672 Belair Rd
Baltimore, MD 21236-4088

Mailing address

1212 York Rd
Suite C-101
Lutherville, MD 21093-6240
Phone (410) 321-0377

Other identifiers 1

IdentifierTypeStateIssuer
074738600MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20111014000168 MD Practitioner - Physical Therapist in Private Practice 8224200316 Reassigns benefits to 3 organizations
I20230905002005 DC Practitioner - Physical Therapist in Private Practice 8224200316 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
International Neurorehabilitation InstituteGroup PAC ID 3476784190, 3 clinicians
Maryland Luna Care Physical Therapy LLCGroup PAC ID 4284017419, 123 clinicians

Practice addresses (Care Compare)

1447 York Rd
Suite 508
Lutherville, MD 21093-6022
Phone (410) 828-4629

5425 Wisconsin Ave
Suite 600
Chevy Chase, MD 20815-3588
Phone (866) 525-3175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21987MDMDSports Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
LHMG Physical Therapy, LLC Physical Therapist CurrentSince Oct 24, 2024 Accepting new patients
Medstar Health Physical Therapy at Home, LLC. Physical Therapist CurrentSince Nov 16, 2023 Accepting new patients
Maryland Luna Care Physical Therapy LLC Physical Therapist CurrentSince Aug 21, 2023 Accepting new patients
LHMG Physical Therapy, LLC Physical Therapist CurrentSince Oct 24, 2024 Accepting new patients
Medstar Health Physical Therapy at Home, LLC. Physical Therapist CurrentSince Nov 16, 2023 Accepting new patients
LHMG Physical Therapy, LLC Physical Therapist Current Accepting new patients
Mady and Mules, PA Past Accepting new patients

Locations

5425 Wisconsin Ave
Ste 600
Chevy Chase, MD 20815
Phone (202) 223-3077

10980 Grantchester Way
Columbia, MD 21044
Phone (301) 202-1073

1106 Annapolis Rd
Ste 120
Odenton, MD 21113
Phone (410) 674-1650

8109 Ritchie Hwy
Ste 600
Pasadena, MD 21122
Phone (410) 553-3515

Organizations & group practices 8

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": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1336260413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 YORK RD",
            "address_2": "SUITE C-101",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936240",
            "telephone_number": "410-321-0377",
            "fax_number": "410-821-7517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7672 BELAIR RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212364088",
            "telephone_number": "410-663-6450",
            "fax_number": "410-663-6451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONSRA BOADI",
        "first_name": "ADWOA",
        "middle_name": "K",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "MD",
            "license": "21987",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MD",
            "license": "21987",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "21987",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "074738600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.