Individual provider Active NPI

Duane D Mellinger, PTA

  • Physical Therapist
  • Columbia, MD
National Provider Identifier
1376727628
Registry record updated Aug 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
27616 Issued in MD
Practice address
10710 Charter Dr
Columbia, MD 21044-3128
Phone
(410) 644-1880
Fax
(410) 730-1617
NPI assigned
Dec 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 27616 MD Primary
Physical Therapy Assistant 225200000X PTA002429 GA

Addresses

Primary practice location

10710 Charter Dr
Columbia, MD 21044-3128

Mailing address

10710 Charter Dr
Columbia, MD 21044-3128
Phone (410) 644-1880

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191011001192 MD Practitioner - Physical Therapist in Private Practice 4880925437 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centers for Advanced Orthopaedics LLCGroup PAC ID 8123260981, 599 clinicians

Practice addresses (Care Compare)

10710 Charter Dr
Suite 300
Columbia, MD 21044-3260
Phone (410) 644-1880

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27616MDMDPharmacist
PTA002429GAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Centers for Advanced Orthopaedics, LLC CurrentSince Sep 1, 2019 Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Sep 1, 2019 Accepting new patients
Centers for Advanced Orthopaedics, LLC Current Accepting new patients
Orthopaedic Associates of Central Maryland, PA Past Accepting new patients
East Athens Physical Therapy Inc PastSince Mar 1, 2005 Accepting new patients

Locations

910 Frederick Rd
Catonsville, MD 21228

12143 Clarksville Pike
Ste 101
Clarksville, MD 21029
Phone (443) 230-5339

10710 Charter Dr
Ste 300
Columbia, MD 21044
Phone 4106441880450

10285 Little Patuxent Pkwy
Ste 400
Columbia, MD 21044

8610 Washington Blvd
Ste 200
Jessup, MD 20794
Phone (410) 824-8149

5961 Exchange Dr
Ste 100
Sykesville, MD 21784
Phone (410) 964-2212

405 N Center St
Ste 28
Westminster, MD 21157

Organizations & group practices 5

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": "1198195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1376727628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10710 CHARTER DR",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443128",
            "telephone_number": "410-644-1880",
            "fax_number": "410-730-1617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10710 CHARTER DR",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443128",
            "telephone_number": "410-644-1880",
            "fax_number": "410-730-1617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLINGER",
        "first_name": "DUANE",
        "middle_name": "D",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-21",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "27616",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "PTA002429",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2019; 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.