Individual provider Active NPI

Nisrin Abdel Rahman

  • Physical Therapist
  • Columbia, MD
National Provider Identifier
1386165231
Registry record updated Aug 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
26457 Issued in MD
Practice address
7080 Deepage Dr
Columbia, MD 21045-5219
Phone
(410) 381-7000
NPI assigned
Jun 30, 2017
Last updated
Aug 7, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2017

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 26457 MD Primary

Addresses

Primary practice location

7080 Deepage Dr
Columbia, MD 21045-5219

Mailing address

PO Box 69014
Baltimore, MD 21264-9014
Phone (410) 885-4616

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170915001316 MD Practitioner - Physical Therapist in Private Practice 6305110206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maryland Sportscare and Rehab LLCGroup PAC ID 2860440427, 166 clinicians

Practice addresses (Care Compare)

2875 Crain Hwy
Suite 6
Waldorf, MD 20601-2841
Phone (301) 859-3304

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26457MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland Sportscare & Rehab LLC Physical Therapist CurrentSince Jun 23, 2017 Accepting new patients
Maryland Sportscare & Rehab, LLC Physical Therapist CurrentSince Jun 23, 2017 Accepting new patients

Locations

7080 Deepage Dr
Columbia, MD 21045
Phone (301) 498-2212

3551 Washington Blvd
Lansdowne, MD 21227
Phone (443) 566-4260

25 Main St
Ste A
Reisterstown, MD 21136
Phone (410) 833-8300

2875 Crain Hwy
Ste 6
Waldorf, MD 20601
Phone (301) 859-3304

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1498780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502064000000",
    "number": "1386165231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 69014",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212649014",
            "telephone_number": "410-885-4616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7080 DEEPAGE DR",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210455219",
            "telephone_number": "410-381-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDEL RAHMAN",
        "first_name": "NISRIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-30",
        "last_updated": "2017-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "26457",
            "primary": true
        }
    ],
    "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 7, 2017; 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.