Active NPI
Zachary Fosdick
- Physical Therapist
- Bethesda, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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
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 100
- Quality
- 89.12
- Improvement activities
- 40
- Cost
- 73.46
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29612 | MD | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ati Holdings, LLC | Physical Therapist | Current | Accepting new patients |
| Ati Holdings, LLC | Physical Therapist | Current | 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.
-
- Physical Therapy Clinic/Center
- Rising Sun, MD
- NPI 1396781050
DC, Physical Therapist
-
- Durable Medical Equipment & Medical Supplies
- King of Prussia, PA
- NPI 1750194460
Physical Therapist
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.