Individual provider Active NPI

Edreelie Dela Rosa Corpuz

  • Physical Therapist
  • Baltimore, MD
National Provider Identifier
1447113402
Registry record updated Dec 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
30461 Issued in MD
Practice address
5955 Western Run Dr Apt B
Baltimore, MD 21209-4051
Phone
(443) 991-3939
NPI assigned
Dec 6, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2025

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 30461 MD Primary

Addresses

Primary practice location

5955 Western Run Dr Apt B
Baltimore, MD 21209-4051

Mailing address

5955 Western Run Dr Apt B
Baltimore, MD 21209-4051
Phone (443) 991-3939

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260225000048 MD Practitioner - Physical Therapist in Private Practice 6800377151 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3401 Box Hill Corporate Ctr Dr
Suite 120
Abingdon, MD 21009-1251
Phone (410) 377-8900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30461MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Centers for Advanced Orthopaedics, LLC CurrentSince Jan 12, 2026 Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Jan 12, 2026 Accepting new patients
Orthopaedic Associates of Central Maryland, PA Past Accepting new patients

Locations

3401 Box Hill Corporate Center Dr
Ste 120
Abingdon, MD 21009

10710 Charter Dr
Ste 300
Columbia, MD 21044
Phone 4106441880450

Organizations & group practices 4

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": "1764979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764979200000",
    "number": "1447113402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5955 WESTERN RUN DR APT B",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212094051",
            "telephone_number": "443-991-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5955 WESTERN RUN DR APT B",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212094051",
            "telephone_number": "443-991-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORPUZ",
        "first_name": "EDREELIE",
        "middle_name": "DELA ROSA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-12-06",
        "last_updated": "2025-12-06",
        "certification_date": "2025-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "30461",
            "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 Dec 6, 2025; 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.