Individual provider Active NPI

Zachary Fosdick

  • Physical Therapist
  • Bethesda, MD
National Provider Identifier
1376328567
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
4611 Sangamore Rd Ste G
Bethesda, MD 20816-2547
Phone
(240) 802-5199
Fax
(240) 219-2120
NPI assigned
Aug 28, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

4611 Sangamore Rd Ste G
Bethesda, MD 20816-2547

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other practice location 1

3003 Van Ness St NW Apt S1108
Washington, DC 20008-4708
Phone (585) 233-5655

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230918001958 DC Practitioner - Physical Therapist in Private Practice 9032573548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ati Holdings, LLCGroup PAC ID 9537112719, 440 clinicians

Practice addresses (Care Compare)

4611 Sangamore Rd
Suite G
Bethesda, MD 20816-2547
Phone (240) 802-5199

Merit-based Incentive Payment System (MIPS)

Final score
86.05 of 100Reported as group
Quality
89.12
Improvement activities
40
Cost
73.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29612MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings, LLC Physical Therapist CurrentSince Aug 14, 2023 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Aug 14, 2023 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

4611 Sangamore Rd
Ste G
Bethesda, MD 20816
Phone (240) 802-5199

12151 Darnestown Rd
Gaithersburg, MD 20878
Phone (301) 591-5109

11271 New Hampshire Ave
Silver Spring, MD 20904
Phone (240) 485-1280

Organizations & group practices 2

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": "1693180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1376328567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4611 SANGAMORE RD STE G",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208162547",
            "telephone_number": "240-802-5199",
            "fax_number": "240-219-2120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3003 Van Ness St NW Apt S1108",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200084708",
            "country_code": "US",
            "telephone_number": "585-233-5655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOSDICK",
        "first_name": "ZACHARY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-28",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "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 Sep 5, 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.