Kenneth Embrack, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

17571 Issued in MD

Practice address

6196 Oxon Hill Rd
Suite 450
Oxon Hill, MD 20745-3100

Phone

(301) 581-8054

Fax

(301) 564-0284

NPI assigned

Dec 18, 2006

Last updated

Jul 8, 2007By 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

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Maryland Sportscare and Rehab LLCGroup PAC ID 2860440427, 166 clinicians

Professional Sportscare and Rehab LLCGroup PAC ID 9335137363, 103 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Professional Sportscare & Rehab, LLC

  dba Pivot Physical Therapy of Metro DC

  • Clinic/Center
  • Winchester, VA
  • NPI 1033142294

  DC, MD, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Maryland Sportscare & Rehab LLC

  dba Pivot Physical Therapy of Maryland

  • Physical Therapist
  • Westminster, MD
  • NPI 1518951995

  DC

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861555328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6410 ROCKLEDGE DR",
            "address_2": "NRH REGIONAL REHAB - SUITE 600",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208171809",
            "telephone_number": "301-581-8054",
            "fax_number": "301-564-0284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6196 OXON HILL RD",
            "address_2": "SUITE 450",
            "city": "OXON HILL",
            "state": "MD",
            "postal_code": "207453100",
            "telephone_number": "301-581-8054",
            "fax_number": "301-564-0284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMBRACK",
        "first_name": "KENNETH",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "17571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Oxon Hill, MD
• Providers in Oxon Hill, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.