Individual provider Active NPI

Loren Lynn Roberts, DPT

  • Physical Therapist
  • Prince Frederick, MD
National Provider Identifier
1619357431
Registry record updated Dec 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
25497 Issued in MD
Practice address
220 Solomons Island Rd N
Prince Frederick, MD 20678-3926
Phone
(410) 885-4710
NPI assigned
Jun 6, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2016

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 25497 MD Primary

Addresses

Primary practice location

220 Solomons Island Rd N
Prince Frederick, MD 20678-3926

Mailing address

501 Fairmount Ave
Ste 302
Towson, MD 21286-5457
Phone (410) 927-8768

Other names 1

  • Loren Lynn Fierstein Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150701001742 MD Practitioner - Physical Therapist in Private Practice 8426360587 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maryland Sportscare and Rehab LLCGroup PAC ID 2860440427, 166 clinicians
Professional Sportscare and Rehab LLCGroup PAC ID 9335137363, 103 clinicians

Practice addresses (Care Compare)

745 Solomons Island Rd N
Prince Frederick, MD 20678-3916
Phone (410) 885-4710

8420 Bayside Rd
Chesapeake Beach, MD 20732-3309
Phone (443) 964-5656

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25497MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Sportscare & Rehab, LLC Physical Therapist CurrentSince Jun 16, 2015 Accepting new patients

Locations

2987 Plaza Dr
Dunkirk, MD 20754
Phone (443) 964-6348

220 Solomons Island Rd N
Prnc Frederck, MD 20678
Phone (410) 535-4884

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": "1433548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480982400000",
    "number": "1619357431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 FAIRMOUNT AVE",
            "address_2": "STE 302",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212865457",
            "telephone_number": "410-927-8768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 SOLOMONS ISLAND RD N",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206783926",
            "telephone_number": "410-885-4710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "LOREN",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-06",
        "last_updated": "2016-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "25497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LOREN",
            "last_name": "FIERSTEIN",
            "middle_name": "LYNN",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Prince Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2016; 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.