Individual provider Active NPI

Paul D Simonetti, DPT

  • Physical Therapist
  • Chestertown, MD
National Provider Identifier
1609802636
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
19425 Issued in MD
Practice address
201 Talbot Blvd Ste W
Chestertown, MD 21620-3000
Phone
(410) 778-3445
Fax
(410) 778-3702
NPI assigned
Jun 23, 2006
Last updated
Feb 28, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 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 19425 MD Primary

Addresses

Primary practice location

201 Talbot Blvd Ste W
Chestertown, MD 21620-3000

Mailing address

201 Talbot Blvd Ste W
Chestertown, MD 21620-3000
Phone (410) 778-3445

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040517000619 MD Practitioner - Physical Therapist in Private Practice 1850381278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

201 Talbot Blvd W
Chestertown Ortho
Chestertown, MD 21620-3000
Phone (410) 778-3445

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19425MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Centers for Advanced Orthopaedics, LLC CurrentSince Dec 1, 2015 Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Dec 1, 2015 Accepting new patients
Centers for Advanced Orthopaedics, LLC Current Accepting new patients
Orthopaedic Associates of Central Maryland, PA Past Accepting new patients
Centers for Advanced Orthopaedics, LLC Past Accepting new patients

Locations

201 Talbot Blvd
Ste W
Chestertown, MD 21620
Phone (410) 778-3445

818 High St
Ste 2
Chestertown, MD 21620
Phone (410) 275-8156

360 E Pulaski Hwy
Ste 2B
Elkton, MD 21921
Phone (410) 403-5075

86 Thomas Johnson Ct
Frederick, MD 21702
Phone (301) 607-0444

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1609802636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 TALBOT BLVD STE W",
            "city": "CHESTERTOWN",
            "state": "MD",
            "postal_code": "216203000",
            "telephone_number": "410-778-3445",
            "fax_number": "410-778-3702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 TALBOT BLVD STE W",
            "city": "CHESTERTOWN",
            "state": "MD",
            "postal_code": "216203000",
            "telephone_number": "410-778-3445",
            "fax_number": "410-778-3702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONETTI",
        "first_name": "PAUL",
        "middle_name": "D",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "19425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chestertown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.