Individual provider Active NPI

Elizabeth Ann Nowak, P.T.

  • Physical Therapist
  • Edgewater, MD
National Provider Identifier
1730128000
Registry record updated Sep 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305203789 Issued in VA
Practice address
3179 Braverton St Ste 201
Edgewater, MD 21037-2667
Phone
(410) 956-4308
NPI assigned
Jun 5, 2006
Last updated
Sep 28, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305203789 VA Primary
Physical Therapist 225100000X 23844 MD

Addresses

Primary practice location

3179 Braverton St Ste 201
Edgewater, MD 21037-2667

Mailing address

3179 Braverton St Ste 201
Edgewater, MD 21037-2667
Phone (410) 956-4308

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120830000312 MD Practitioner - Physical Therapist in Private Practice 7012909971 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305203789VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sage Physical Therapy & Wellness LLC Physical Therapist CurrentSince Jan 1, 2025 Accepting new patients
Bayside Physical Therapy & Sports Rehabilitation Limited Partnership Physical Therapist PastSince Sep 26, 2016 Accepting new patients
Loudoun Physical Therapy, Inc. Physical Therapist PastSince Oct 1, 1998 Accepting new patients
Virginia Hospital Center Arlington Health System Past Accepting new patients

Locations

3536A Urbana Pike
Urbana, MD 21704
Phone (301) 874-9200

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475020800000",
    "number": "1730128000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3179 BRAVERTON ST STE 201",
            "city": "EDGEWATER",
            "state": "MD",
            "postal_code": "210372667",
            "telephone_number": "410-956-4308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3179 BRAVERTON ST STE 201",
            "city": "EDGEWATER",
            "state": "MD",
            "postal_code": "210372667",
            "telephone_number": "410-956-4308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWAK",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2016-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305203789",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "23844",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewater, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2016; 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.