NPIMap

Organization Active NPI

Eastern Shore Physical Therapy

  • Physical Therapist
  • Berlin, MD
National Provider Identifier
1356473318
Registry record updated Sep 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
18883 Issued in MD
Legal business name
EASTERN SHORE PHYSICAL THERAPY
Practice address
314 Franklin Ave Ste 405
Berlin, MD 21811-1263
Phone
(410) 641-2900
Fax
(410) 641-2914
NPI assigned
Mar 12, 2007
Last updated
Sep 11, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2018

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

Authorized official

Name
Mr. Martin Weinstein, PTNPI 1013083526
Title
President
Phone
(410) 641-2900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 19301 MD
Physical Therapist 225100000X 18883 MD Primary
Physical Therapy Assistant 225200000X A2461 MD

Addresses

Primary practice location

314 Franklin Ave Ste 405
Berlin, MD 21811-1263

Mailing address

314 Franklin Ave Ste 405
Berlin, MD 21811-1263
Phone (410) 641-2900

Other identifiers 1

IdentifierTypeStateIssuer
402788400MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050209000647 MD Part B Supplier - Clinic/Group Practice 9739130527 Receives reassigned benefits from 5 practitioners
Practice locations: Berlin, MD

National Provider Directory

National Provider Directory

Locations

10776 Grays Corner Rd
Unit 4
Berlin, MD 21811
Phone (410) 251-6858

314 Franklin Ave
Ste 405
Berlin, MD 21811
Phone (410) 641-2900

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536624000000",
    "number": "1356473318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 FRANKLIN AVE STE 405",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218111263",
            "telephone_number": "410-641-2900",
            "fax_number": "410-641-2914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 FRANKLIN AVE STE 405",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218111263",
            "telephone_number": "410-641-2900",
            "fax_number": "410-641-2914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN SHORE PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2018-09-11",
        "status": "A",
        "authorized_official_last_name": "WEINSTEIN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-641-2900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "19301",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "18883",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MD",
            "license": "A2461",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "402788400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.