David Ethan Ebbecke, DPT, MBA

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305005642 Issued in VA

Practice address

8551 Rixlew LN
Suite 340
Manassas, VA 20109-4277

Phone

(703) 368-7343

Fax

(703) 368-0719

NPI assigned

Jul 27, 2006

Last updated

Nov 6, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Piedmont Physical Therapy IncGroup PAC ID 6709935935, 9 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

86.67 of 100Reported as individual

Quality

73.33

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Business Administration

Practice roles

Locations

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.

• Piedmont Physical Therapy, Inc

  • Physical Therapist
  • Manassas, VA
  • NPI 1194968768
  Medicare reassignment Care Compare group NPD Authorized official
• Mizener & Associates Physical Therapy

  dba David S Mizener PT

  • Physical Therapist
  • Manassas, VA
  • NPI 1912921545
  NPD (past)

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415232000000",
    "number": "1811901978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8551 RIXLEW LN",
            "address_2": "SUITE 340",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201094277",
            "telephone_number": "703-368-7343",
            "fax_number": "703-368-0719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8551 RIXLEW LN",
            "address_2": "SUITE 340",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201094277",
            "telephone_number": "703-368-7343",
            "fax_number": "703-368-0719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBBECKE",
        "first_name": "DAVID",
        "middle_name": "ETHAN",
        "credential": "DPT, MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2014-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305005642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BLUE CROSS AND BLUE SHIELD",
            "identifier": "Q395-0002",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Reno Jackson Dykes, MD
• E Carrington Family Enrichment Center, Inc.
• Sini Eapen, NURSE PRACTITIONER
• April L Easter, LPC
• Easy Medical Transportation
• Olivia Ebey, PA-C
• Theophiline Mary Ebiasah
• Raymond Eck, LPC
• Christopher David Edens, MD
• Edmund Stephen Petrilli, M.D., P.C.

• Physical Therapist in Manassas, VA
• Providers in Manassas, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2014; 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.