Poolesville Physical Therapy
Organization Active NPI Physical Therapy Clinic/Center · Poolesville, MD
NPI 1396880100 · NPPES record last updated Apr 1, 2008
Key facts
- NPI
- 1396880100
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapy Clinic/Center 261QP2000X
- License
- 15401 (MD)
- Legal business name
- POOLESVILLE PHYSICAL THERAPY
- Practice address
- 19628 Fisher Ave
Poolesville, MD 20837-2065 - Phone
- (301) 349-5443
- Fax
- (301) 349-2074
- NPI assigned
- Feb 20, 2007
- Organization subpart
- No
Authorized official
- Name
- Mrs. Patricia Kapsiak Hess, PT
- Title
- Owner
- Phone
- (301) 349-5443
Practitioners 1
-
Patricia Kapsiak Hess, P.T.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080324000179 | DC | Part B Supplier - Clinic/Group Practice | 7618053299 |
Receives reassigned benefits from 1 practitioner Practice locations: Poolesville, MD |
National Provider Directory
Locations
19628 Fisher Ave
Poolesville, MD 20837
Phone (301) 349-5443
19628 Fisher Ave
Ste A
Poolesville, MD 20837
Phone (301) 349-5443
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | 15401 | MD | Yes |
Addresses
Primary practice location
19628 Fisher Ave
Poolesville, MD 20837-2065
Mailing address
19628 Fisher Ave
Poolesville, MD 20837-2065
Phone (301) 349-5443
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15401 | Other | MD | STATE LICENSE |
Other providers in Poolesville, MD
- Robin Mevissen
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- Sarah Merie Paksima
- Emily E Pavlick
- Poolesville Family Practice LLC
- Poolesville Vision and Contact Lens Service
- Possible Rays Wellness, LLC
- Emma Ridgway
- Danielle Marie Roche
- Erica Salpino
All providers in Poolesville, MD · Physical Therapy Clinic/Center in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 1, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.