Individual provider Active NPI

Caroline Delceta Black, PT

  • Military Health Care Provider
  • Bethesda, MD
National Provider Identifier
1346460698
Registry record updated May 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military Health Care ProviderTaxonomy code 171000000X
License
17660 Issued in MD
Practice address
National Naval Medical Center Rockville Pike
Bethesda, MD 20850
Phone
(301) 295-4880
NPI assigned
Apr 27, 2007
Reactivated
May 23, 2023
Last updated
May 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Military Health Care Provider 171000000X 17660 MD Primary

Addresses

Primary practice location

National Naval Medical Center Rockville Pike
Bethesda, MD 20850

Mailing address

13116 Ardennes Ave
Rockville, MD 20851-2332
Phone (301) 540-1886

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA, MD3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20080408000633 DC Practitioner - Physical Therapist in Private Practice 8022195510 Reassigns benefits to 3 organizations
I20230717002912 VA Practitioner - Physical Therapist in Private Practice 8022195510 Reassigns benefits to 1 organization
I20251104000023 MD Practitioner - Physical Therapist in Private Practice 8022195510 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehabilitation Services LLCGroup PAC ID 1355347410, 304 clinicians

Practice addresses (Care Compare)

17051 Oakmont Ave
Suite D
Gaithersburg, MD 20877-4142
Phone (240) 543-6572

9885 Greenbelt Rd
Lanham, MD 20706-2302
Phone (877) 407-3422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17660MDMDEEG Specialist/Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehab PT MD LLC CurrentSince Oct 1, 2025 Accepting new patients
Fox Rehabilitation Services LLC CurrentSince Oct 1, 2025 Accepting new patients
Healthy Checkups LLC CurrentSince Sep 27, 2021 Accepting new patients
Functional Pathways Preferred of Tennessee LLC CurrentSince May 1, 2023 Accepting new patients
Excel Rehabilitation, PLLC CurrentSince Jun 9, 2025 Accepting new patients
Capitol Orthopaedics and Rehabilitation, LLC Past Accepting new patients

Locations

17051 Oakmont Ave
Ste B
Gaithersburg, MD 20877
Phone (240) 543-6572

17051 Oakmont Ave
Ste D
Gaithersburg, MD 20877
Phone (240) 543-6572

11665 Doolittle Dr
Waldorf, MD 20602
Phone (301) 638-4100

10133 Sherrill Blvd
Ste 200
Knoxville, TN 37932
Phone (865) 392-2847

10521 Rosehaven St
Ste LL150
Fairfax, VA 22030
Phone (703) 383-1616

3317 Ocean Shore Ave
Virginia Beach, VA 23451
Phone (757) 232-3179

Organizations & group practices 7

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": "1177632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1346460698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13116 ARDENNES AVE",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208512332",
            "telephone_number": "301-540-1886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NATIONAL NAVAL MEDICAL CENTER ROCKVILLE PIKE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "20850",
            "telephone_number": "301-295-4880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "CAROLINE",
        "middle_name": "DELCETA",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-27",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "deactivation_date": "2023-05-04",
        "reactivation_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "MD",
            "license": "17660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; 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.