Regina Ann Puthen Purackal, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

17682 Issued in MD

Practice address

613 Hammonds LN
Brooklyn Park, MD 21225-3351

Phone

(410) 350-8514

NPI assigned

Jul 1, 2008

Sex

Female

Sole proprietor

Yes

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, MD2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fox Rehab PT MD LLCGroup PAC ID 6709028822, 92 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.

• Fox Rehab PT MD LLC

  • Physical Therapist
  • Timonium, MD
  • NPI 1588901847
  Medicare reassignment Care Compare group NPD
• Fox Rehabilitation Services LLC

  • Physical Therapist
  • Winchester, VA
  • NPI 1609814755

  DC

  Medicare reassignment NPD

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425945600000",
    "number": "1639331515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 FELLOWSHIP WAY",
            "city": "ODENTON",
            "state": "MD",
            "postal_code": "211132425",
            "telephone_number": "443-472-5630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 HAMMONDS LN",
            "city": "BROOKLYN PARK",
            "state": "MD",
            "postal_code": "212253351",
            "telephone_number": "410-350-8514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURACKAL",
        "first_name": "REGINA",
        "middle_name": "ANN PUTHEN",
        "name_prefix": "Miss",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-01",
        "last_updated": "2015-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "17682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Priority Home Care of Maryland
• Project Chesapeake LLC
• Project Chesapeake LLC
• Project Chesapeake, LLC
• Project Chesapeake, LLC
• Remedy Therapy
• Alexis Marie Roberson, LCPC
• Nichole Marie Rosado, RN, CNM
• Second Chance Behavioral Health Center LLC
• Second Chance Behavioral Health Center LLC

• Physical Therapist in Brooklyn Park, MD
• Providers in Brooklyn Park, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2015; 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.