Individual provider Active NPI

Mitchell Alton McDonald

  • Physical Therapist
  • Cambridge, MD
National Provider Identifier
1699645143
Registry record updated Nov 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
30696 Issued in MD
Practice address
321 Dorchester Ave Ste B
Cambridge, MD 21613-2425
Phone
(410) 228-5100
NPI assigned
Nov 10, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 30696 MD Primary

Addresses

Primary practice location

321 Dorchester Ave Ste B
Cambridge, MD 21613-2425

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20251209001015 MD Practitioner - Physical Therapist in Private Practice 4789178666 Reassigns benefits to 1 organization
I20251209001115 DC Practitioner - Physical Therapist in Private Practice 4789178666 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maryland Sportscare and Rehab LLCGroup PAC ID 2860440427, 166 clinicians

Practice addresses (Care Compare)

321 Dorchester Ave
Suite B
Cambridge, MD 21613-2425
Phone (410) 228-5100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30696MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland Sportscare & Rehab, LLC Physical Therapist CurrentSince Nov 20, 2025 Accepting new patients
Maryland Sportscare & Rehab LLC Physical Therapist CurrentSince Nov 20, 2025 Accepting new patients

Locations

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

321 Dorchester Ave
Ste B
Cambridge, MD 21613
Phone (410) 228-5100

9815 Main St
Ste 206
Damascus, MD 20872
Phone (301) 253-6761

141 Thomas Johnson Dr
Ste 180
Frederick, MD 21702
Phone (301) 620-7478

25 Main St
Ste A
Reisterstown, MD 21136
Phone (410) 833-8300

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1762732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763942400000",
    "number": "1699645143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 DORCHESTER AVE STE B",
            "city": "CAMBRIDGE",
            "state": "MD",
            "postal_code": "216132425",
            "telephone_number": "410-228-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "MITCHELL",
        "middle_name": "ALTON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-11-10",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "30696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2025; 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.