Individual provider Active NPI

Abiola O Fakile, PT, DPT

  • Pediatric Physical Therapist
  • Washington, DC
National Provider Identifier
1639740616
Registry record updated Jul 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
Practice address
3801 Connecticut Ave NW # 100
Washington, DC 20008-4530
Phone
(202) 525-1641
NPI assigned
Jul 9, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X Primary

Addresses

Primary practice location

3801 Connecticut Ave NW # 100
Washington, DC 20008-4530

Mailing address

2350 Washington PL NE Apt 407
Washington, DC 20018-1073
Phone (770) 873-1681

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221014001137 GA Practitioner - Physical Therapist in Private Practice 4789050808 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Howard University College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emory Physical Therapy, LLCGroup PAC ID 1153382676, 96 clinicians
Georgia Luna Care Physical Therapy LLCGroup PAC ID 4082027727, 167 clinicians
1Source Fitness and Sports-Neuro Rehab LLCGroup PAC ID 4183888316, 3 clinicians

Practice addresses (Care Compare)

21 Ortho LN
Atlanta, GA 30329-2315
Phone (404) 778-3350

260 Peachtree St NW
Suite 2200
Atlanta, GA 30303-1292
Phone (866) 525-3175

367 Athens Hwy
Suite 1150
Loganville, GA 30052-2270
Phone 67825740371002

Merit-based Incentive Payment System (MIPS)

Final score
82.85 of 100Reported as group
Quality
85.59
Improvement activities
40
Cost
69.27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Physical Therapy, LLC CurrentSince Dec 15, 2024 Accepting new patients
1Source Fitness & Sports-Neuro Rehab LLC Pediatrics CurrentSince Jun 20, 2022 Accepting new patients
Coastal Healthcare Services, Inc CurrentSince Jul 17, 2021 Accepting new patients
Georgia Luna Care Physical Therapy LLC CurrentSince Aug 9, 2024 Accepting new patients
Emory Physical Therapy, LLC Current Accepting new patients
Emory Physical Therapy, LLC CurrentSince Dec 15, 2024 Accepting new patients

Locations

21 Ortho Ln
Atlanta, GA 30329
Phone (404) 778-2516

260 Peachtree St NW
Ste 2200
Atlanta, GA 30303
Phone (669) 231-6870

1845 Satellite Blvd
Ste 750
Duluth, GA 30097
Phone (404) 778-6490

1670 McKendree Church Rd
Ste 40
Lawrenceville, GA 30043
Phone (678) 257-4037

367 Athens Hwy
Ste 1150
Loganville, GA 30052
Phone (678) 257-4037

Organizations & group practices 6

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": "1625788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1639740616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 WASHINGTON PL NE APT 407",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200181073",
            "telephone_number": "770-873-1681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 CONNECTICUT AVE NW # 100",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200084530",
            "telephone_number": "202-525-1641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAKILE",
        "first_name": "ABIOLA",
        "middle_name": "O",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-09",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2021; 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.