NPIMap

Organization Active NPI

Mosaddegh Physical Therapy Inc

  • Physical Therapist
  • Greenbelt, MD
National Provider Identifier
1376841148
Registry record updated Mar 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MOSADDEGH PHYSICAL THERAPY INC
Practice address
7500 Hanover Parkway
Suite 103
Greenbelt, MD 20770
Phone
(301) 446-1644
Fax
(301) 446-1647
NPI assigned
Mar 3, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2019

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

Authorized official

Name
Sasan Chalezamini
Title
Coo, Cfo
Phone
(301) 446-1644

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

7500 Hanover Parkway
Suite 103
Greenbelt, MD 20770

Mailing address

17902 Georgia Ave Ste 220
Olney, MD 20832-2279
Phone (240) 774-0222

Other names 2

  • Physical Therapy & Sports Medicine Center Doing business as
  • Physical Therapy and Sports Medicine Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110603000514 DC Part B Supplier - Clinic/Group Practice 5698952422 Receives reassigned benefits from 20 practitioners
Practice locations: Greenbelt, MD; Silver Spring, MD; Riverdale, MD; Olney, MD; Laurel, MD; Bowie, MD
O20180827000450 MD Part B Supplier - Clinic/Group Practice 5698952422 Receives reassigned benefits from 2 practitioners
Practice locations: Glen Burnie, MD

National Provider Directory

National Provider Directory
Tax ID family
Mosaddegh Physical Therapy9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7301 E Furnace Branch Rd
Ste A
Glen Burnie, MD 21060
Phone (443) 422-3500

14113 Baltimore Ave
#B
Laurel, MD 20707
Phone (301) 347-4737

6510 Kenilworth Ave
Ste 1100
Riverdale, MD 20737
Phone (240) 427-1755

6510 Kenilworth Ave
Ste 100
Riverdale, MD 20737

1680 E Gude Dr
Ste 200
Rockville, MD 20850

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1299110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553817600000",
    "number": "1376841148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17902 GEORGIA AVE STE 220",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208322279",
            "telephone_number": "240-774-0222",
            "fax_number": "240-774-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 HANOVER PARKWAY",
            "address_2": "SUITE 103",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "20770",
            "telephone_number": "301-446-1644",
            "fax_number": "301-446-1647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSADDEGH PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-03",
        "last_updated": "2019-03-29",
        "status": "A",
        "authorized_official_last_name": "CHALEZAMINI",
        "authorized_official_first_name": "SASAN",
        "authorized_official_title_or_position": "COO, CFO",
        "authorized_official_telephone_number": "301-446-1644"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physical Therapy & Sports Medicine Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Physical Therapy and Sports Medicine Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Physical Therapy and Sports Medicine Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenbelt, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2019; 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.