Individual provider Active NPI

Madoka Aoyama Bean

  • Physical Therapist
  • Glen Allen, VA
National Provider Identifier
1760235444
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305207108 Issued in VA
Practice address
5109 Arrowbrook CT
Glen Allen, VA 23060-2876
Phone
(866) 839-6979
NPI assigned
Apr 10, 2024
Last updated
Apr 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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 2305207108 VA Primary

Addresses

Primary practice location

5109 Arrowbrook CT
Glen Allen, VA 23060-2876

Mailing address

5109 Arrowbrook CT
Glen Allen, VA 23060-2876
Phone (866) 839-6979

Other names 1

  • Madoka Aoyama Former name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240426001319 VA Practitioner - Physical Therapist in Private Practice 1951741743 Reassigns benefits to 2 organizations
I20240504000040 DC Practitioner - Physical Therapist in Private Practice 1951741743 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305207108VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Therapeutics LTD Physical Therapist CurrentSince May 17, 2024 Accepting new patients
Comprehensive Therapeutics LTD Physical Therapist CurrentSince May 17, 2024 Accepting new patients

Locations

10286 Brook Rd
Glen Allen, VA 23059
Phone (571) 200-6617

Organizations & group practices 3

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": "1712707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1760235444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5109 ARROWBROOK CT",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230602876",
            "telephone_number": "866-839-6979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5109 ARROWBROOK CT",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230602876",
            "telephone_number": "866-839-6979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAN",
        "first_name": "MADOKA",
        "middle_name": "AOYAMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-10",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305207108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADOKA",
            "last_name": "AOYAMA",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Glen Allen, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; 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.