Active NPI
McTheophilus Borillo Barizo III
- Physical Therapist
- Washington, DC
National Provider Identifier
1689260796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT872712
- Practice address
- 102 Irving St NW
Washington, DC 20010-2921 - Phone
- (202) 877-1000
- NPI assigned
- Dec 14, 2020
- 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 | PT872712 | DC | Primary |
Addresses
Primary practice location
102 Irving St NW
Washington, DC 20010-2921
Mailing address
304 Woodland Rd
Rockville, MD 20850-1666
Phone (301) 466-5364
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT872712 | DC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607904000000",
"number": "1689260796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "304 WOODLAND RD",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208501666",
"telephone_number": "301-466-5364"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 IRVING ST NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200102921",
"telephone_number": "202-877-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARIZO",
"first_name": "MCTHEOPHILUS",
"middle_name": "BORILLO",
"name_suffix": "III",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-14",
"last_updated": "2020-12-14",
"certification_date": "2020-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "DC",
"license": "PT872712",
"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 Dec 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.