Individual provider Active NPI

Paula Cristina Caccavale, DPT

  • Physical Therapist
  • Rockville, MD
National Provider Identifier
1457836124
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
27210 Issued in MD
Practice address
3204 Tower Oaks Blvd Ste 150
Rockville, MD 20852-4211
Phone
(301) 468-9343
Fax
(301) 230-2127
NPI assigned
Sep 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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 27210 MD Primary

Addresses

Primary practice location

3204 Tower Oaks Blvd Ste 150
Rockville, MD 20852-4211

Mailing address

3204 Tower Oaks Blvd Ste 150
Rockville, MD 20852-4211
Phone (301) 468-9343

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

LicenseStateTypeSpecialty
27210MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Early Intervention Associates, LLC Physical Therapist CurrentSince Jun 9, 2024 Accepting new patients

Locations

6208 Montrose Rd
Rockville, MD 20852
Phone (301) 468-9343

3204 Tower Oaks Blvd
Ste 150
Rockville, MD 20852
Phone (301) 468-9343

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, 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": "1538092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1457836124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3204 TOWER OAKS BLVD STE 150",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524211",
            "telephone_number": "301-468-9343",
            "fax_number": "301-230-2127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3204 TOWER OAKS BLVD STE 150",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524211",
            "telephone_number": "301-468-9343",
            "fax_number": "301-230-2127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CACCAVALE",
        "first_name": "PAULA",
        "middle_name": "CRISTINA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-28",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "27210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; 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.