NPIMap

Organization Active NPI

Chesapeake Bay Aquatic & Physical Therapy, Inc

  • Physical Therapy Clinic/Center
  • Laurel, MD
National Provider Identifier
1831411271
Registry record updated May 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
CHESAPEAKE BAY AQUATIC & PHYSICAL THERAPY, INC
Practice address
314 Marshall Ave
Laurel, MD 20707-4823
Phone
(301) 498-2212
Fax
(301) 498-2213
NPI assigned
Feb 26, 2010
Last updated
May 19, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2010

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

Authorized official

Name
Morris B Goldman
Title
Owner
Phone
(301) 262-5852

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X MD Primary

Addresses

Primary practice location

314 Marshall Ave
Laurel, MD 20707-4823

Mailing address

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

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
Practice locations: Bowie, MD; Laurel, MD

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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

Locations

13946 Baltimore Ave
Laurel, MD 20707
Phone (301) 262-5852

204 Fort Meade Rd
Laurel, MD 20707
Phone (301) 957-4234

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1267142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274227200000",
    "number": "1831411271",
    "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": "314 MARSHALL AVE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207074823",
            "telephone_number": "301-498-2212",
            "fax_number": "301-498-2213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESAPEAKE BAY AQUATIC & PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-26",
        "last_updated": "2010-05-19",
        "status": "A",
        "authorized_official_last_name": "GOLDMAN",
        "authorized_official_first_name": "MORRIS",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-262-5852"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2010; 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.