Individual provider Active NPI

Mayur Goli

  • Physical Therapist
  • Towson, MD
National Provider Identifier
1730450289
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
23923 Issued in MD
Practice address
509 E Joppa Rd
Towson, MD 21286-5404
Phone
(410) 828-9494
NPI assigned
Jan 14, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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 5501015212 MI
Physical Therapist 225100000X 23923 MD Primary

Addresses

Primary practice location

509 E Joppa Rd
Towson, MD 21286-5404

Mailing address

742 Leister Dr
Lutherville Timonium, MD 21093-7418
Phone (906) 360-9507

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241205001275 MD Practitioner - Physical Therapist in Private Practice 5799211439 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Healthcare SolutionsGroup PAC ID 4880120526, 3 clinicians

Practice addresses (Care Compare)

110 Painters Mill Rd
Suite 206
Owings Mills, MD 21117-5251
Phone (906) 360-9507

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23923MDMDMental Health Counselor
5501015212MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpro Heritage Rehab & Fitness, LLC Physical Therapist CurrentSince Nov 5, 2024 Accepting new patients
Integrated Healthcare Solutions Physical Therapist CurrentSince Sep 21, 2024 Accepting new patients
Primary NP Associates CurrentSince Sep 21, 2024 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Physical Therapist CurrentSince Nov 5, 2024 Accepting new patients

Locations

100 Brightwood Club Dr
Lutherville, MD 21093
Phone (410) 729-6552

110 Painters Mill Rd
Ste 206
Owings Mills, MD 21117
Phone (410) 356-4680

2525 Pot Spring Rd
Timonium, MD 21093
Phone (410) 308-9702

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": "1326499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1730450289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "742 LEISTER DR",
            "city": "LUTHERVILLE TIMONIUM",
            "state": "MD",
            "postal_code": "210937418",
            "telephone_number": "906-360-9507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 E JOPPA RD",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212865404",
            "telephone_number": "410-828-9494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLI",
        "first_name": "MAYUR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-14",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501015212",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "23923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; 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.