Andrea Marie Eisgruber, P.T.

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

22720 Issued in MD

Practice address

10989 Red Run Blvd
Suite 200
Owings Mills, MD 21117-3283

Phone

(410) 654-7525

Fax

(410) 654-7535

NPI assigned

Dec 7, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Andrea Marie Venetz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Indigo Roland Park LLC

  dba Indigo Physiotherapy

  • Physical Therapy Clinic/Center
  • Baltimore, MD
  • NPI 1134866809

  Sports

  NPD
• Mady and Mules, PA

  • Physical Medicine & Rehabilitation Physician
  • Baltimore, MD
  • NPI 1265096382
  NPD (past)
• Physiotherapy Associates Inc

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Estero, FL
  • NPI 1720039902
  NPD (past)

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

{
    "created_epoch": "1260144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397347200000",
    "number": "1730417551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10989 RED RUN BLVD",
            "address_2": "SUITE 200",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211173283",
            "telephone_number": "410-654-7525",
            "fax_number": "410-654-7535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10989 RED RUN BLVD",
            "address_2": "SUITE 200",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211173283",
            "telephone_number": "410-654-7525",
            "fax_number": "410-654-7535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISGRUBER",
        "first_name": "ANDREA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-07",
        "last_updated": "2014-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "MD",
            "license": "22720",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MD",
            "license": "22720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EHP",
            "identifier": "228204",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHMSI",
            "identifier": "6545-0020",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "963129-01",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "VENETZ",
            "middle_name": "MARIE",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Orthopedic Physical Therapist in Owings Mills, MD
• Providers in Owings Mills, MD by specialty
• Orthopedic Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.