Individual provider Active NPI

Paul Moroney, PT

  • Physical Therapist
  • Owings Mills, MD
National Provider Identifier
1801103544
Registry record updated Jul 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
20112 Issued in MD
Practice address
23 Crossroads Dr
Suite 300
Owings Mills, MD 21117-5420
Phone
(410) 998-9133
Fax
(410) 338-3155
NPI assigned
Sep 1, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2013

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 20112 MD Primary

Addresses

Primary practice location

23 Crossroads Dr
Suite 300
Owings Mills, MD 21117-5420

Mailing address

23 Crossroads Dr
Suite 300
Owings Mills, MD 21117-5420
Phone (410) 998-9133

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131008000393 MD Practitioner - Physical Therapist in Private Practice 6507090453

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Koman Orthopedics and Sports Medicine, LLC CurrentSince May 5, 2014 Accepting new patients
Life Fitness Physical Therapy LLC Physical Therapist Past Accepting new patients
Life Fitness Physical Therapy LLC Physical Therapist Past Accepting new patients

Locations

116 Westminster Pike
Ste 100
Reisterstown, MD 21136
Phone (410) 833-9300

116 Westminster Pike
Ste 101
Reisterstown, MD 21136

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1283299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374537600000",
    "number": "1801103544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 CROSSROADS DR",
            "address_2": "SUITE 300",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175420",
            "telephone_number": "410-998-9133",
            "fax_number": "410-338-3155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 CROSSROADS DR",
            "address_2": "SUITE 300",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175420",
            "telephone_number": "410-998-9133",
            "fax_number": "410-338-3155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORONEY",
        "first_name": "PAUL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-01",
        "last_updated": "2013-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "20112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owings Mills, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2013; 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.