Individual provider Active NPI

Christian Tae Ho Han, M.P.T.

  • Physical Therapist
  • Silver Spring, MD
National Provider Identifier
1477607109
Registry record updated Jul 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
20173 Issued in MD
Practice address
3836 International Dr
Silver Spring, MD 20906-1548
Phone
(301) 598-7420
Fax
(301) 598-7432
NPI assigned
Jan 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2017

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 20173 MD Primary

Addresses

Primary practice location

3836 International Dr
Silver Spring, MD 20906-1548

Mailing address

8492 Baltimore National Pike
Ste 207
Ellicott City, MD 21043-3378
Phone (301) 776-0421

Other identifiers 5

IdentifierTypeStateIssuer
338063OtherMDMAMSI LIFE MD IPA
683203200OtherMDAMERIGROUP
LK24ATOtherMDCF BLUE CROSS BLUE SHIELD
S9860005OtherDCCF BLUE CROSS BLUE SHIELD
4039165MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170801001423 MD Practitioner - Physical Therapist in Private Practice 0547274086 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

8492 Baltimore National Pike
Suite 207
Ellicott City, MD 21043-3378
Phone (410) 988-8520

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20173MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Active Care Physical Therapy and Rehabilitation Center, LLC Physical Therapist CurrentSince Jul 1, 2017 Accepting new patients
Atlantic Physical Therapy and Rehab Center LTD Physical Therapist Past Accepting new patients

Locations

8492 Baltimore National Pike
Ste 207
Ellicott City, MD 21043
Phone (410) 418-4060

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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499817600000",
    "number": "1477607109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8492 BALTIMORE NATIONAL PIKE",
            "address_2": "STE 207",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210433378",
            "telephone_number": "301-776-0421",
            "fax_number": "301-598-7432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3836 INTERNATIONAL DR",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209061548",
            "telephone_number": "301-598-7420",
            "fax_number": "301-598-7432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAN",
        "first_name": "CHRISTIAN",
        "middle_name": "TAE HO",
        "credential": "M.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2017-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "20173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI LIFE MD IPA",
            "identifier": "338063",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "683203200",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CF BLUE CROSS BLUE SHIELD",
            "identifier": "LK24AT",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CF BLUE CROSS BLUE SHIELD",
            "identifier": "S9860005",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4039165",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2017; 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.