Individual provider Active NPI

Toshita Hemant Ambegaonkar, PT

  • Physical Therapist
  • Waldorf, MD
National Provider Identifier
1386204782
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
27342 Issued in MD
Practice address
2875 Crain Hwy Ste 6
Waldorf, MD 20601-2841
Phone
(301) 859-3304
Fax
(301) 383-8305
NPI assigned
Jun 18, 2019
Last updated
May 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 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 27342 MD Primary

Addresses

Primary practice location

2875 Crain Hwy Ste 6
Waldorf, MD 20601-2841

Mailing address

350 New Fidelity CT
Garner, NC 27529-2665
Phone (919) 373-2919

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191114000031 DC Practitioner - Physical Therapist in Private Practice 9133551088 Reassigns benefits to 2 organizations
I20230516003695 MD Practitioner - Physical Therapist in Private Practice 9133551088 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Sportscare and Rehab LLCGroup PAC ID 9335137363, 103 clinicians

Practice addresses (Care Compare)

2875 Crain Hwy
Suite 6
Waldorf, MD 20601-2807
Phone (301) 859-3304

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27342MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Sportscare & Rehab, LLC Physical Therapist CurrentSince May 1, 2023 Accepting new patients
Sports Pro Physical Therapy South LLC Physical Therapist CurrentSince Sep 15, 2019 Accepting new patients

Locations

2987 Plaza Dr
Dunkirk, MD 20754
Phone (443) 964-6348

930 E Swan Creek Rd
Ft Washington, MD 20744
Phone (301) 292-9400

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

1600 Wilson Blvd
Ste 102
Arlington, VA 22209
Phone (301) 464-4500

Organizations & group practices 3

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": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1386204782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 NEW FIDELITY CT",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275292665",
            "telephone_number": "919-373-2919",
            "fax_number": "410-648-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2875 CRAIN HWY STE 6",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206012841",
            "telephone_number": "301-859-3304",
            "fax_number": "301-383-8305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBEGAONKAR",
        "first_name": "TOSHITA",
        "middle_name": "HEMANT",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-18",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "27342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.