NPIMap

Organization Active NPI

Genesis Physiatry Consultants LLC

  • Physical Medicine & Rehabilitation Physician
  • Halethorpe, MD
National Provider Identifier
1386354017
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
GENESIS PHYSIATRY CONSULTANTS LLC
Practice address
3320 Benson Ave
Halethorpe, MD 21227-1035
Phone
(732) 986-3795
NPI assigned
Dec 5, 2022
Last updated
Jul 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Authorized official

Name
Rubeena VincentNPI 1316580954
Title
Owner
Phone
(732) 986-3795

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X Primary

Addresses

Primary practice location

3320 Benson Ave
Halethorpe, MD 21227-1035

Mailing address

8508 Queen Elizabeth Blvd
Annandale, VA 22003-4308

Other practice location 1

8508 Queen Elizabeth Blvd
Annandale, VA 22003-4308
Phone (732) 986-3795

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC, MD3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20230424003041 VA Part B Supplier - Clinic/Group Practice 5698130771 Receives reassigned benefits from 5 practitioners
Practice locations: Woodbridge, VA
O20230808002679 DC Part B Supplier - Clinic/Group Practice 5698130771 Receives reassigned benefits from 4 practitioners
Practice locations: Annandale, VA
O20250527002634 MD Part B Supplier - Clinic/Group Practice 5698130771 Receives reassigned benefits from 3 practitioners
Practice locations: Baltimore, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1670198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752710400000",
    "number": "1386354017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8508 QUEEN ELIZABETH BLVD",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220034308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 BENSON AVE",
            "city": "HALETHORPE",
            "state": "MD",
            "postal_code": "212271035",
            "telephone_number": "732-986-3795"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8508 Queen Elizabeth Blvd",
            "address_purpose": "LOCATION",
            "city": "Annandale",
            "state": "VA",
            "postal_code": "220034308",
            "country_code": "US",
            "telephone_number": "732-986-3795",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GENESIS PHYSIATRY CONSULTANTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-05",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A",
        "authorized_official_last_name": "VINCENT",
        "authorized_official_first_name": "RUBEENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-986-3795"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Halethorpe, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2025; 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.