Active NPI
Edison G Robles, PT
- Physical Therapist
- Abingdon, MD
National Provider Identifier
1457596033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 22751
- Practice address
- 1311 Continental Dr
Suite R
Abingdon, MD 21009-2333 - Phone
- (410) 676-0997
- NPI assigned
- Dec 10, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 22751 | MD | Primary |
Addresses
Primary practice location
1311 Continental Dr
Suite R
Abingdon, MD 21009-2333
Mailing address
10015 Old Columbia Rd
Suite B 215
Columbia, MD 21046-1703
Phone (410) 356-6161
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22751 | MD | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Barry Michaelson Physical Therapy, Inc. | Physical Therapist | Past | Accepting new patients |
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.
-
- Geriatric Physical Therapist
- Pikesville, MD
- NPI 1942208186
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228867200000",
"number": "1457596033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10015 OLD COLUMBIA RD",
"address_2": "SUITE B 215",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210461703",
"telephone_number": "410-356-6161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1311 CONTINENTAL DR",
"address_2": "SUITE R",
"city": "ABINGDON",
"state": "MD",
"postal_code": "210092333",
"telephone_number": "410-676-0997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBLES",
"first_name": "EDISON",
"middle_name": "G",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-12-10",
"last_updated": "2008-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "22751",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Abingdon, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.