NPIMap

Organization Active NPI

Home Physical Therapy Services

  • Physical Therapist
  • Ellicott City, MD
National Provider Identifier
1811032865
Registry record updated Jul 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
16690 Issued in MD
Legal business name
HOME PHYSICAL THERAPY SERVICES
Practice address
3130 Evergreen Way
Ellicott City, MD 21042-1024
Phone
(410) 531-7558
Fax
(410) 531-7558
NPI assigned
Feb 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Monica Morales, PTNPI 1033254073
Title
Sole Proprietor
Phone
(410) 531-7558

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X 16690 MD Primary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X 15420 MD

Addresses

Primary practice location

3130 Evergreen Way
Ellicott City, MD 21042-1024

Mailing address

3130 Evergreen Way
Ellicott City, MD 21042-1024
Phone (410) 531-7558

Other identifiers 1

IdentifierTypeStateIssuer
KAF3OtherMDBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040103000033 MD Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1456250927 Receives reassigned benefits from 1 practitioner
Practice locations: Ellicott City, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216166400000",
    "number": "1811032865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3130 EVERGREEN WAY",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210421024",
            "telephone_number": "410-531-7558",
            "fax_number": "410-531-7558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 EVERGREEN WAY",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210421024",
            "telephone_number": "410-531-7558",
            "fax_number": "410-531-7558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME PHYSICAL THERAPY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2008-07-16",
        "status": "A",
        "authorized_official_last_name": "MORALES",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "410-531-7558",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "16690",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "15420",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "KAF3",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; 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.