Active NPI
Samuel Robert Monticello, PT, DPT
- Physical Therapist
- Rockville, MD
National Provider Identifier
1528527702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 27337
- Practice address
- 1407 Research Blvd
Rockville, MD 20850-3159 - Phone
- (240) 813-1856
- Fax
- (240) 813-1859
- NPI assigned
- Mar 18, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2305212657 | VA | |
| Physical Therapist | 225100000X | 27337 | MD | Primary |
Addresses
Primary practice location
1407 Research Blvd
Rockville, MD 20850-3159
Mailing address
PO Box 1769
Middleburg, VA 20118-1769
Phone (540) 687-8181
Other practice location 1
8250 Greensboro Dr
Mc Lean, VA 22102-4902
Phone (703) 388-0288
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27337 | MD | MD | Physical Therapist |
| 2305212657 | VA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Jackson Clinics LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Middleburg, VA
- NPI 1427034982
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556150400000",
"number": "1528527702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1769",
"city": "MIDDLEBURG",
"state": "VA",
"postal_code": "201181769",
"telephone_number": "540-687-8181",
"fax_number": "540-687-8256"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1407 RESEARCH BLVD",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208503159",
"telephone_number": "240-813-1856",
"fax_number": "240-813-1859"
}
],
"practiceLocations": [
{
"address_1": "8250 Greensboro Dr",
"address_purpose": "LOCATION",
"city": "Mc Lean",
"state": "VA",
"postal_code": "221024902",
"country_code": "US",
"telephone_number": "703-388-0288",
"fax_number": "703-388-0290",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MONTICELLO",
"first_name": "SAMUEL",
"middle_name": "ROBERT",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-03-18",
"last_updated": "2019-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305212657",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "27337",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.