Individual provider Active NPI

Christopher Banaga Sy, PT

  • Physical Therapist
  • Ellicott City, MD
National Provider Identifier
1881985992
Registry record updated Apr 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
23077 Issued in MD
Practice address
3290 N Ridge Rd Ste 290
Ellicott City, MD 21043-3657
Phone
(410) 750-9006
NPI assigned
Apr 23, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 23077 MD Primary

Addresses

Primary practice location

3290 N Ridge Rd Ste 290
Ellicott City, MD 21043-3657

Mailing address

3290 N Ridge Rd Ste 290
Ellicott City, MD 21043-3657

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140908000125 FL Practitioner - Physical Therapist in Private Practice 1759509623 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23077MDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Rehabilitation Florida, LLC Physical Therapist CurrentSince Oct 30, 2023 Accepting new patients
Empowerme Rehabilitation Florida, LLC CurrentSince Oct 30, 2023 Accepting new patients

Locations

6945 Carlisle Ct
Naples, FL 34109
Phone (239) 249-6877

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1303516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303516800000",
    "number": "1881985992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3290 N RIDGE RD STE 290",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210433657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3290 N RIDGE RD STE 290",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210433657",
            "telephone_number": "410-750-9006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SY",
        "first_name": "CHRISTOPHER",
        "middle_name": "BANAGA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-23",
        "last_updated": "2011-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "23077",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 23, 2011; 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.