Individual provider Active NPI

Alisa Meredith Pravdo, DPT

  • Physical Therapist
  • Baltimore, MD
National Provider Identifier
1518212158
Registry record updated Jul 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
24097 Issued in MD
Practice address
100 S Charles St
Suite 150
Baltimore, MD 21201-2725
Phone
(410) 752-3010
NPI assigned
Jul 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2012

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 24097 MD Primary

Addresses

Primary practice location

100 S Charles St
Suite 150
Baltimore, MD 21201-2725

Mailing address

1300 Saint Paul St
Apt 9
Baltimore, MD 21202-2715

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180124002778 MD Practitioner - Physical Therapist in Private Practice 4789943572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

22 S Green St
Baltimore, MD 21201-1544
Phone (410) 328-6704

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24097MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Orthopaedic Associates PA CurrentSince Dec 10, 2017 Accepting new patients
University of Maryland Orthopaedic Associates P a CurrentSince Dec 10, 2017 Accepting new patients

Locations

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

226 Schilling Cir
Ste 170
Hunt Valley, MD 21031
Phone (240) 315-6800

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": "1342656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342656000000",
    "number": "1518212158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 SAINT PAUL ST",
            "address_2": "APT 9",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S CHARLES ST",
            "address_2": "SUITE 150",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212012725",
            "telephone_number": "410-752-3010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRAVDO",
        "first_name": "ALISA",
        "middle_name": "MEREDITH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-19",
        "last_updated": "2012-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "24097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2012; 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.