Individual provider Active NPI

Casondra Lippy

  • Physical Therapist
  • Baltimore, MD
National Provider Identifier
1790560159
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
3850 Boston St Apt 4060
Baltimore, MD 21224-5772
Phone
(717) 965-3806
NPI assigned
Aug 25, 2023
Last updated
Jun 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 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 NU Primary

Addresses

Primary practice location

3850 Boston St Apt 4060
Baltimore, MD 21224-5772

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230914000476 MD Practitioner - Physical Therapist in Private Practice 4183088891 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ati Holdings, LLCGroup PAC ID 9537112719, 440 clinicians

Practice addresses (Care Compare)

871 E Fort Ave
Unit 17
Baltimore, MD 21230-5117
Phone (410) 622-3310

Merit-based Incentive Payment System (MIPS)

Final score
86.05 of 100Reported as group
Quality
89.12
Improvement activities
40
Cost
73.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings, LLC Physical Therapist CurrentSince Aug 28, 2023 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Aug 28, 2023 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

2400 Boston St
Ste 114
Baltimore, MD 21224
Phone (410) 826-6585

711 W 40th St
Ste 170
Baltimore, MD 21211
Phone (667) 600-4560

871 E Fort Ave
Unit 17
Baltimore, MD 21230
Phone (410) 622-3310

11301 York Rd
Cockeysville, MD 21030
Phone (443) 541-1912

1401 Merritt Blvd
Ste D
Dundalk, MD 21222
Phone (443) 530-9750

117 Orville Rd
Essex, MD 21221
Phone (410) 686-2270

1510 Rock Spring Rd
Ste C
Forest Hill, MD 21050
Phone (410) 420-3619

52 Rising Sun Town Ctr
Rising Sun, MD 21911
Phone (410) 658-0100

Organizations & group practices 2

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": "1692921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1790560159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 BOSTON ST APT 4060",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212245772",
            "telephone_number": "717-965-3806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPPY",
        "first_name": "CASONDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-25",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 3, 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.