Individual provider Active NPI

Briana Fedorko, DPT

  • Physical Therapist
  • Berlin, MD
National Provider Identifier
1497129423
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
25766 Issued in MD
Practice address
314 Franklin Ave
Suite 501
Berlin, MD 21811-1215
Phone
(410) 641-0999
NPI assigned
Nov 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 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 25766 MD Primary

Addresses

Primary practice location

314 Franklin Ave
Suite 501
Berlin, MD 21811-1215

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other names 1

  • Briana Lee Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20151231000589 MD Practitioner - Physical Therapist in Private Practice 8426350836 Reassigns benefits to 3 organizations
I20200618001478 DC Practitioner - Physical Therapist in Private Practice 8426350836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ati Holdings, LLCGroup PAC ID 9537112719, 440 clinicians
Dickson Physical Therapy, LLCGroup PAC ID 1254873599, 4 clinicians

Practice addresses (Care Compare)

1409 S Salisbury Blvd
Unit CD
Salisbury, MD 21801-7151
Phone (667) 330-1061

329 Tilghman Rd
Suite 200
Salisbury, MD 21804-2078
Phone (443) 203-8522

Merit-based Incentive Payment System (MIPS)

Final score
86.05 of 100Reported as group
Quality
89.12
Improvement activities
40
Cost
73.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25766MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings, LLC Physical Therapist CurrentSince Oct 11, 2021 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Oct 11, 2021 Accepting new patients
Dickson Physical Therapy, LLC Physical Therapist CurrentSince Apr 1, 2026 Accepting new patients
Maryland Sportscare & Rehab LLC Physical Therapist CurrentSince Jun 5, 2020 Accepting new patients
Maryland Sportscare & Rehab, LLC Physical Therapist CurrentSince Jun 5, 2020 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

711 W 40th St
Ste 170
Baltimore, MD 21211
Phone (667) 600-4560

314 Franklin Ave
Ste 501
Berlin, MD 21811
Phone (410) 228-5100

9815 Main St
Ste 206
Damascus, MD 20872
Phone (301) 253-6761

401 Marvel Ct
Easton, MD 21601
Phone (410) 820-4449

141 Thomas Johnson Dr
Ste 180
Frederick, MD 21702
Phone (301) 620-7478

2634 Brandermill Blvd
Gambrills, MD 21054
Phone (410) 721-7201

12913 Coastal Hwy
Ocean City, MD 21842
Phone (410) 213-7878

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

52 Rising Sun Town Ctr
Rising Sun, MD 21911
Phone (410) 658-0100

329 Tilghman Rd
Ste 200
Salisbury, MD 21804
Phone (443) 203-8522

1409 S Salisbury Blvd
Unit Cd
Salisbury, MD 21801
Phone (667) 330-1061

2420 N Salisbury Blvd
Unit 5
Salisbury, MD 21801
Phone (410) 546-4952

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

Organizations & group practices 5

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": "1447372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1497129423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 FRANKLIN AVE",
            "address_2": "SUITE 501",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218111215",
            "telephone_number": "410-641-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDORKO",
        "first_name": "BRIANA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-13",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "25766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIANA",
            "last_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Berlin, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; 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.