Individual provider Active NPI

Jessica Lynn Raab, PT, DPT

  • Physical Therapist
  • Aberdeen, MD
National Provider Identifier
1467953612
Registry record updated Feb 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
26875 Issued in MD
Practice address
744 S Philadelphia Blvd Ste C
Aberdeen, MD 21001-3602
Phone
(410) 339-1951
Fax
(410) 505-0229
NPI assigned
Feb 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2018

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 26875 MD Primary

Addresses

Primary practice location

744 S Philadelphia Blvd Ste C
Aberdeen, MD 21001-3602

Mailing address

501 Fairmount Ave Ste 302
Towson, MD 21286-5494
Phone (410) 927-8768

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180419002787 MD Practitioner - Physical Therapist in Private Practice 4981967288 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maryland Sportscare and Rehab LLCGroup PAC ID 2860440427, 166 clinicians

Practice addresses (Care Compare)

744 S Philadelphia Blvd
Suite C
Aberdeen, MD 21001-3655
Phone (410) 339-1951

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26875MDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland Sportscare & Rehab LLC Physical Therapist CurrentSince Feb 28, 2018 Accepting new patients
Maryland Sportscare & Rehab, LLC Physical Therapist CurrentSince Feb 28, 2018 Accepting new patients

Locations

744 S Philadelphia Blvd
Ste C
Aberdeen, MD 21001
Phone (410) 339-1951

25 Main St
Ste A
Reisterstown, MD 21136
Phone (410) 833-8300

501 Fairmount Ave
Ste 302
Towson, MD 21286
Phone (410) 927-8768

Organizations & group practices 2

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": "1519344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519344000000",
    "number": "1467953612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 FAIRMOUNT AVE STE 302",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212865494",
            "telephone_number": "410-927-8768",
            "fax_number": "410-648-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 S PHILADELPHIA BLVD STE C",
            "city": "ABERDEEN",
            "state": "MD",
            "postal_code": "210013602",
            "telephone_number": "410-339-1951",
            "fax_number": "410-505-0229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAAB",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-23",
        "last_updated": "2018-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "26875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2018; 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.