NPIMap

Organization Active NPI

Somerset Physical Therapy

  • Sports Physical Therapist
  • Princess Anne, MD
National Provider Identifier
1629476296
Registry record updated Dec 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physical TherapistTaxonomy code 2251S0007X
License
15888 Issued in MD
Legal business name
SOMERSET PHYSICAL THERAPY
Practice address
12302 Somerset Avenue
Suite C
Princess Anne, MD 21853-1312
Phone
(410) 543-9000
Fax
(410) 543-9033
NPI assigned
Dec 15, 2014
Organization subpart
Yes
Parent organization
SALISBURY PHYSICAL THERAPY & SPORTS MEDICINEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 15, 2014

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

Authorized official

Name
Robert S. Bartoshesky, P.T.NPI 1538130505
Title
Owner/President
Phone
(410) 543-9000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251S0007X 15888 MD Primary

Addresses

Primary practice location

12302 Somerset Avenue
Suite C
Princess Anne, MD 21853-1312

Mailing address

949 Mount Hermon Rd
Salisbury, MD 21804-5105
Phone (410) 543-9000

Other identifiers 2

IdentifierTypeStateIssuer
071378300MedicaidMD
S4020001OtherMDCAREFIRST

National Provider Directory

National Provider Directory
Tax ID family
Salisbury Physical Therapy Sportsmedicine5 organizations share this tax ID, including this one
Part of
Salisbury Physical Therapy Sportsmedicine

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

12302 Somerset Ave
Ste C
Princess Anne, MD 21853
Phone (410) 543-9000

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1418601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418601600000",
    "number": "1629476296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "949 MOUNT HERMON RD",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218045105",
            "telephone_number": "410-543-9000",
            "fax_number": "410-543-9033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12302 SOMERSET AVENUE",
            "address_2": "SUITE C",
            "city": "PRINCESS ANNE",
            "state": "MD",
            "postal_code": "218531312",
            "telephone_number": "410-543-9000",
            "fax_number": "410-543-9033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOMERSET PHYSICAL THERAPY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SALISBURY PHYSICAL THERAPY & SPORTS MEDICINE",
        "enumeration_date": "2014-12-15",
        "last_updated": "2014-12-15",
        "status": "A",
        "authorized_official_last_name": "BARTOSHESKY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "410-543-9000",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Sports",
            "state": "MD",
            "license": "15888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "071378300",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "S4020001",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Princess Anne, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.