NPIMap

Organization Active NPI

Ace Physical Therapy & Sports Medicine Institute, LLC

  • Physical Therapist
  • Vienna, VA
National Provider Identifier
1689952640
Registry record updated Aug 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ACE PHYSICAL THERAPY & SPORTS MEDICINE INSTITUTE, LLC
Practice address
8230 Boone Blvd Ste 202
Vienna, VA 22182-2647
Phone
(703) 205-1233
Fax
(703) 641-0189
NPI assigned
Jul 25, 2011
Last updated
Aug 28, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2012

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

Authorized official

Name
Michael A Ercole, PT
Title
Institute Director
Phone
(703) 205-1233

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

8230 Boone Blvd Ste 202
Vienna, VA 22182-2647

Mailing address

2841 Hartland Rd Ste 401B
Falls Church, VA 22043-3500
Phone (703) 205-1233

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070301000072 DC Part B Supplier - Clinic/Group Practice 3173625787 Receives reassigned benefits from 12 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Herndon, VA; Vienna, VA; Falls Church, VA; Arlington, VA; Alexandria, VA; Fairfax, VA

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Ace Physical Therapy Sports9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

NPI Registry JSON

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

{
    "created_epoch": "1311552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346112000000",
    "number": "1689952640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2841 HARTLAND RD STE 401B",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220433500",
            "telephone_number": "703-205-1233",
            "fax_number": "703-641-0189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8230 BOONE BLVD STE 202",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822647",
            "telephone_number": "703-205-1233",
            "fax_number": "703-641-0189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACE PHYSICAL THERAPY & SPORTS MEDICINE INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-25",
        "last_updated": "2012-08-28",
        "status": "A",
        "authorized_official_last_name": "ERCOLE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "INSTITUTE DIRECTOR",
        "authorized_official_telephone_number": "703-205-1233",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.