Organization Active NPI

Ace Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Herndon, VA
National Provider Identifier
1407605702
Registry record updated May 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
ACE PHYSICAL THERAPY, LLC
Practice address
108 Elden St Ste 12
Herndon, VA 20170-4886
Phone
(703) 464-0425
Fax
(703) 464-0426
NPI assigned
May 17, 2024
Last updated
May 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2024

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

Authorized official

Name
Michael Ercole, MSPT
Title
Managing Member
Phone
(703) 205-1233

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU Primary

Addresses

Primary practice location

108 Elden St Ste 12
Herndon, VA 20170-4886

Mailing address

108 Elden St Ste 12
Herndon, VA 20170-4886
Phone (703) 464-0425

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241031003592 DC Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0840723623 Receives reassigned benefits from 9 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Alexandria, VA; Arlington, VA; Fairfax, VA; Falls Church, VA; Herndon, VA; Vienna, VA

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1715904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715904000000",
    "number": "1407605702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 ELDEN ST STE 12",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704886",
            "telephone_number": "703-464-0425",
            "fax_number": "703-464-0426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 ELDEN ST STE 12",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704886",
            "telephone_number": "703-464-0425",
            "fax_number": "703-464-0426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACE PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-17",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A",
        "authorized_official_last_name": "ERCOLE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "703-205-1233",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Herndon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; 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.