NPIMap

Organization Active NPI

Pivot Physical Therapy of Central Maryland LLC

  • Clinic/Center
  • Ellicott City, MD
National Provider Identifier
1477211704
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PIVOT PHYSICAL THERAPY OF CENTRAL MARYLAND LLC
Practice address
3570 Saint Johns LN Ste 13
Ellicott City, MD 21042-4037
Phone
(410) 461-6776
NPI assigned
Dec 3, 2021
Last updated
Oct 1, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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

Authorized official

Name
Juana Granados
Title
Credentialing Director
Phone
(630) 575-1980

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary
Physical Therapist 225100000X NU
Occupational Therapist 225X00000X NU

Addresses

Primary practice location

3570 Saint Johns LN Ste 13
Ellicott City, MD 21042-4037

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (252) 248-3313

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20250107001411 DC Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3173051042 Receives reassigned benefits from 5 practitioners
Practice locations: Laurel, MD
O20250113000763 MD Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3173051042 Receives reassigned benefits from 8 practitioners
Practice locations: Ellicott, MD; Frederick, MD; Owings Mills, MD

National Provider Directory

National Provider Directory
Tax ID family
Pivot Physical Therapy of Central Maryland LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3570 Saint Johns Ln
Ste 13
Ellicott City, MD 21042
Phone (410) 461-6776

545 Main St
Ste 117
Laurel, MD 20707
Phone (301) 497-8980

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1638489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759276800000",
    "number": "1477211704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "252-248-3313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3570 SAINT JOHNS LN STE 13",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210424037",
            "telephone_number": "410-461-6776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIVOT PHYSICAL THERAPY OF CENTRAL MARYLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-03",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A",
        "authorized_official_last_name": "GRANADOS",
        "authorized_official_first_name": "JUANA",
        "authorized_official_title_or_position": "CREDENTIALING DIRECTOR",
        "authorized_official_telephone_number": "630-575-1980"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.