Individual provider Active NPI

Cary Alexander Bonci

  • Physical Therapist
  • Gaithersburg, MD
National Provider Identifier
1528580693
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
26477 Issued in MD
Practice address
828 Muddy Branch Rd Ste 14
Gaithersburg, MD 20878-2780
Phone
(301) 685-1311
Fax
(301) 685-1336
NPI assigned
Jul 11, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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 26477 MD Primary

Addresses

Primary practice location

828 Muddy Branch Rd Ste 14
Gaithersburg, MD 20878-2780

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2222

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170829003222 MD Practitioner - Physical Therapist in Private Practice 9335412212 Reassigns benefits to 3 organizations
I20191014001500 DC Practitioner - Physical Therapist in Private Practice 9335412212 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maryland Sportscare and Rehab LLCGroup PAC ID 2860440427, 166 clinicians

Practice addresses (Care Compare)

828 Muddy Branch Rd
Suite 14
Gaithersburg, MD 20878-2780
Phone (301) 685-1311

9815 Main St
Suite 206
Damascus, MD 20872-2099
Phone (301) 253-6761

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland Sportscare & Rehab, LLC Physical Therapist CurrentSince Jul 5, 2017 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Oct 14, 2019 Accepting new patients
Maryland Sportscare & Rehab LLC Physical Therapist CurrentSince Jul 5, 2017 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Oct 14, 2019 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

4740 Cherry Hill Rd
College Park, MD 20740
Phone (240) 965-0999

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

1510 Rock Spring Rd
Ste C
Forest Hill, MD 21050
Phone (410) 420-3619

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

828 Muddy Branch Rd
Ste 14
Gaithersburg, MD 20878
Phone (301) 685-1311

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

11271 New Hampshire Ave
Silver Spring, MD 20904
Phone (240) 485-1280

Organizations & group practices 4

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": "1499731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1528580693",
    "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",
            "telephone_number": "630-296-2222",
            "fax_number": "630-759-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "828 MUDDY BRANCH RD STE 14",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208782780",
            "telephone_number": "301-685-1311",
            "fax_number": "301-685-1336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONCI",
        "first_name": "CARY",
        "middle_name": "ALEXANDER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-11",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "26477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; 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.