Jonathan T Stacey

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

22643 Issued in MD

Practice address

2200 Kernan Dr
Baltimore, MD 21207-6665

Phone

(410) 448-6323

Fax

(410) 448-6338

NPI assigned

Apr 15, 2010

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mosaddegh Physical Therapy IncGroup PAC ID 5698952422, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mosaddegh Physical Therapy Inc

  • Physical Therapist
  • Greenbelt, MD
  • NPI 1376841148

  DC

  Medicare reassignment Care Compare group NPD
• Mosaddegh Physical Therapy Inc.

  • Physical Therapist
  • Silver Spring, MD
  • NPI 1316588767
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1271289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271289600000",
    "number": "1598081564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 KERNAN DR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212076665",
            "telephone_number": "410-448-6323",
            "fax_number": "410-448-6338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 KERNAN DR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212076665",
            "telephone_number": "410-448-6323",
            "fax_number": "410-448-6338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACEY",
        "first_name": "JONATHAN",
        "middle_name": "T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-15",
        "last_updated": "2010-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "22643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlotte St. Pierre, LCSW-C
• Jeremy James St. Thomas
• Paul N Staats, M.D.
• Larissa Leona Stabinski
• Susan Alana Stabler, RPH
• Stephen Stachnik, MD
• Thomas Joseph Stack, MD
• Tavonia Stackhouse
• Chasity L Stacy, LCSW-C
• Marissa Stacy, LCPAT, ATR-BC, CTP

• Physical Therapist in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2010; 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.