Individual provider Active NPI

Trevor Colin Stephenson

  • Physical Therapist
  • Burtonsville, MD
National Provider Identifier
1417544099
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
15630 Old Columbia Pike Ste F
Burtonsville, MD 20866-1617
Phone
(240) 559-5270
NPI assigned
Dec 29, 2020
Last updated
Dec 29, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 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 NU Primary

Addresses

Primary practice location

15630 Old Columbia Pike Ste F
Burtonsville, MD 20866-1617

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210202001156 DC Practitioner - Physical Therapist in Private Practice 1456765577 Reassigns benefits to 1 organization
I20230123002311 MD Practitioner - Physical Therapist in Private Practice 1456765577 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ati Holdings, LLCGroup PAC ID 9537112719, 440 clinicians

Practice addresses (Care Compare)

15630 Old Columbia Pike
Suite F
Burtonsville, MD 20866-1617
Phone (240) 559-5270

Merit-based Incentive Payment System (MIPS)

Final score
86.05 of 100Reported as group
Quality
89.12
Improvement activities
40
Cost
73.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings, LLC Physical Therapist CurrentSince Dec 28, 2020 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Dec 28, 2020 Accepting new patients
Ati Holdings, LLC Past Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

15630 Old Columbia Pike
Ste F
Burtonsville, MD 20866
Phone (240) 559-5270

4740 Cherry Hill Rd
College Park, MD 20740
Phone (240) 965-0999

1510 Rock Spring Rd
Ste C
Forest Hill, MD 21050
Phone (410) 420-3619

2950 Donnell Dr
Ste G
Forestville, MD 20747
Phone (240) 492-3410

2900 Belcrest Center Dr
Ste 104A
Hyattsville, MD 20782
Phone (301) 276-3295

14190 Baltimore Ave
Ste B
Laurel, MD 20707
Phone (240) 542-5924

435 E Ridgeville Blvd
Mount Airy, MD 21771
Phone (240) 732-2334

52 Rising Sun Town Ctr
Rising Sun, MD 21911
Phone (410) 658-0100

2420 N Salisbury Blvd
Unit 5
Salisbury, MD 21801
Phone (410) 546-4952

11271 New Hampshire Ave
Silver Spring, MD 20904
Phone (240) 485-1280

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": "1609200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1417544099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15630 OLD COLUMBIA PIKE STE F",
            "city": "BURTONSVILLE",
            "state": "MD",
            "postal_code": "208661617",
            "telephone_number": "240-559-5270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "TREVOR",
        "middle_name": "COLIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-29",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burtonsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.