Individual provider Active NPI

Sean Vincent McComiskey, PT, DPT

  • Physical Therapist
  • Baltimore, MD
National Provider Identifier
1407336969
Registry record updated May 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
27148 Issued in MD
Practice address
2000 Girard Ave
Baltimore, MD 21211-1595
Phone
(443) 977-4470
Fax
(443) 687-8684
NPI assigned
Aug 15, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2020

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 27148 MD Primary

Addresses

Primary practice location

2000 Girard Ave
Baltimore, MD 21211-1595

Mailing address

611 S Paca St
Baltimore, MD 21230-2411
Phone (443) 977-4470

Other practice location 1

660 Kenilworth Dr Ste 102
Baltimore, MD 21204-2353
Phone (410) 296-9311

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181127002633 MD Practitioner - Physical Therapist in Private Practice 8426392747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

600 Wyndhurst Ave
Suite 100 a
Baltimore, MD 21210-2489
Phone (443) 977-4470

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Birch Tree Physical Therapy and Wellness, LLC Physical Therapist CurrentSince Mar 1, 2020 Accepting new patients

Locations

600 Wyndhurst Ave
Ste 100A
Baltimore, MD 21210
Phone (443) 977-4470

2000 Girard Ave
Baltimore, MD 21211
Phone (410) 929-1596

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588723200000",
    "number": "1407336969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 S PACA ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212302411",
            "telephone_number": "443-977-4470",
            "fax_number": "443-687-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 GIRARD AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212111595",
            "telephone_number": "443-977-4470",
            "fax_number": "443-687-8684"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "660 Kenilworth Dr Ste 102",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212042353",
            "country_code": "US",
            "telephone_number": "410-296-9311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCOMISKEY",
        "first_name": "SEAN",
        "middle_name": "VINCENT",
        "name_prefix": "Mr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-15",
        "last_updated": "2020-05-06",
        "certification_date": "2020-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "27148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2020; 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.