Individual provider Active NPI

Michael Bershak, PT

  • Physical Therapist
  • Baltimore, MD
National Provider Identifier
1780702175
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10230 Issued in MD
Practice address
2700 Quarry Lake Dr Ste 300
Baltimore, MD 21209-3746
Phone
(410) 377-8900
Fax
(410) 377-0576
NPI assigned
Mar 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 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 10230 MD Primary

Addresses

Primary practice location

2700 Quarry Lake Dr Ste 300
Baltimore, MD 21209-3746

Mailing address

1314 Bedford Ave
Suite 108
Pikesville, MD 21208-6604
Phone (410) 484-8899

Other practice location 1

1314 Bedford Ave
Suite 108
Pikesville, MD 21208-6604
Phone (410) 484-8899

Other identifiers 6

IdentifierTypeStateIssuer
2713483OtherMDUNITED PROV #
J061OtherMDBLUE CROSS PROV #
206077OtherMDKAISER PERM PROV #
382298200MedicaidMD
85581OtherMDAMERIGROUP PROV #
215486OtherMDMAMSI PROVIDER #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110309000153 MD Practitioner - Physical Therapist in Private Practice 7214119478 Reassigns benefits to 2 organizations
Practice locations: Columbia, MD

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Maryland School of Medicine, 1967
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centers for Advanced Orthopaedics LLCGroup PAC ID 8123260981, 599 clinicians

Practice addresses (Care Compare)

2700 Quarry Lake Dr
Baltimore, MD 21209-3742
Phone (410) 377-8900

Merit-based Incentive Payment System (MIPS)

Final score
87.93 of 100Reported as group
Quality
86.7
Promoting interoperability
100
Improvement activities
40
Cost
73.06

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10230MDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sage Physical Therapy & Wellness LLC Physical Therapist CurrentSince Mar 5, 2022 Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Jul 15, 2024 Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Jul 15, 2024 Accepting new patients
Orthopaedic Associates of Central Maryland, PA Past Accepting new patients

Locations

2700 Quarry Lake Dr
Ste 300
Baltimore, MD 21209

10710 Charter Dr
Ste 300
Columbia, MD 21044
Phone 4106441880450

86 Thomas Johnson Ct
Frederick, MD 21702
Phone (301) 607-0444

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1780702175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 BEDFORD AVE",
            "address_2": "SUITE 108",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212086604",
            "telephone_number": "410-484-8899",
            "fax_number": "410-484-8569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 QUARRY LAKE DR STE 300",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212093746",
            "telephone_number": "410-377-8900",
            "fax_number": "410-377-0576"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1314 Bedford Ave",
            "address_2": "SUITE 108",
            "address_purpose": "LOCATION",
            "city": "Pikesville",
            "state": "MD",
            "postal_code": "212086604",
            "country_code": "US",
            "telephone_number": "410-484-8899",
            "fax_number": "410-484-8569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERSHAK",
        "first_name": "MICHAEL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "10230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED PROV #",
            "identifier": "2713483",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROV #",
            "identifier": "J061",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER PERM PROV #",
            "identifier": "206077",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "382298200",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP PROV #",
            "identifier": "85581",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI PROVIDER #",
            "identifier": "215486",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; 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.