Genesis Rehab

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

A3840 Issued in MD

Legal business name

GENESIS REHAB

Practice address

1691 Yale PL
Rockville, MD 20850-1115

Phone

(608) 345-3837

NPI assigned

Feb 27, 2015

Organization subpart

No

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

Authorized official

Name

Michael Mironchenko

Title

Physical Therapist Assistant

Phone

(608) 345-3837

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Genesis Rehab Doing business as

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

{
    "created_epoch": "1424995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424995200000",
    "number": "1427440403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1691 YALE PL",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208501115",
            "telephone_number": "608-345-3837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1691 YALE PL",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208501115",
            "telephone_number": "608-345-3837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-27",
        "last_updated": "2015-02-27",
        "status": "A",
        "authorized_official_last_name": "MIRONCHENKO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST ASSISTANT",
        "authorized_official_telephone_number": "608-345-3837"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MD",
            "license": "A3840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1590869",
            "identifier": "1590869",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Genesis Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Gelman, RN
• Mariam Gendy
• Marilyn Genebroso
• Charisa Genelaso
• Genesis Eldercare Physician Services LLC
• Genetic Consultants of Maryland, Inc.
• Lyisha Genies
• Lisa Joy Genser, LCSW
• Lorenzo Keoma Gentle Semple
• Afruica Gentle

• Skilled Nursing Facility in Rockville, MD
• Providers in Rockville, MD by specialty
• Skilled Nursing Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.