Individual provider Active NPI

Michael Lombardo, PTA

  • Physical Therapy Assistant
  • Bowie, MD
National Provider Identifier
1376016485
Registry record updated Jan 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A4533 Issued in MD
Practice address
15500 Annapolis Rd Ste 102
Bowie, MD 20715-3039
Phone
(410) 216-2220
Fax
(443) 481-1140
NPI assigned
Jan 11, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A4533 MD Primary

Addresses

Primary practice location

15500 Annapolis Rd Ste 102
Bowie, MD 20715-3039

Mailing address

15500 Annapolis Rd Ste 102
Bowie, MD 20715-3039
Phone (410) 216-2220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A4533MDMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1547164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547164800000",
    "number": "1376016485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15500 ANNAPOLIS RD STE 102",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207153039",
            "telephone_number": "410-216-2220",
            "fax_number": "443-481-1140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15500 ANNAPOLIS RD STE 102",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207153039",
            "telephone_number": "410-216-2220",
            "fax_number": "443-481-1140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOMBARDO",
        "first_name": "MICHAEL",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-11",
        "last_updated": "2019-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MD",
            "license": "A4533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.