Active NPI
John J Nietubicz, P.T., M.T.C.
- Physical Therapist
- Hunt Valley, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 15837
- Practice address
- 11350 McCormick Rd
Ep IV, LL8
Hunt Valley, MD 21031-1002 - Phone
- (410) 527-1794
- Fax
- (410) 527-9467
- NPI assigned
- Jul 17, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 15837 | MD | Primary |
Addresses
Primary practice location
11350 McCormick Rd
Ep IV, LL8
Hunt Valley, MD 21031-1002
Mailing address
10 Pinecone CT
Baltimore, MD 21234-1509
Phone (410) 668-7535
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1447 York Rd
Suite 401
Lutherville, MD 21093-6063
Phone (410) 529-3303
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| WP-PT LLC | Physical Therapist | Current | Accepting new patients |
| Active Life & Sports Therapy LLC | Physical Therapist | Current | Accepting new patients |
Locations
1447 York Rd
Ste 401
Lutherville Timonium, MD 21093
Phone (410) 842-0115
4337 Ebenezer Rd
Nottingham, MD 21236
Phone (410) 770-2762
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapist
- Nottingham, MD
- NPI 1396836052
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669499158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 PINECONE CT",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212341509",
"telephone_number": "410-668-7535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11350 MCCORMICK RD",
"address_2": "EP IV, LL8",
"city": "HUNT VALLEY",
"state": "MD",
"postal_code": "210311002",
"telephone_number": "410-527-1794",
"fax_number": "410-527-9467"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIETUBICZ",
"first_name": "JOHN",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "P.T., M.T.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "15837",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hunt Valley, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.