NPIMap

Organization Active NPI

Chesapeake Bay Aquatic & Physical Therapy, Inc

  • Physical Therapist
  • Bowie, MD
National Provider Identifier
1811229412
Registry record updated Nov 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
CHESAPEAKE BAY AQUATIC & PHYSICAL THERAPY, INC
Practice address
100 White Marsh Park Dr
Bowie, MD 20715-4361
Phone
(301) 262-5852
Fax
(301) 262-3173
NPI assigned
Feb 5, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2020

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

Authorized official

Name
Ms. Danielle Goldstein, M.P.T.
Title
Director of Operations/PT
Phone
(301) 498-2212

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

100 White Marsh Park Dr
Bowie, MD 20715-4361

Mailing address

PO Box 4058
Crofton, MD 21114-4058
Phone (301) 262-5852

Other names 1

  • Chesapeake Physical & Aquatic Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100602000505 DC Part B Supplier - Clinic/Group Practice 0749319788 Receives reassigned benefits from 7 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bowie, MD; Laurel, MD

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Chesapeake Bay Aquatic Physical Therapy Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the 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": "1265328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605139200000",
    "number": "1811229412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4058",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211144058",
            "telephone_number": "301-262-5852",
            "fax_number": "301-262-3173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WHITE MARSH PARK DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207154361",
            "telephone_number": "301-262-5852",
            "fax_number": "301-262-3173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESAPEAKE BAY AQUATIC & PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-05",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A",
        "authorized_official_last_name": "GOLDSTEIN",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS/PT",
        "authorized_official_telephone_number": "301-498-2212",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chesapeake Physical & Aquatic Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Chesapeake Physical & Aquatic Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bowie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2020; 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.