Individual provider Active NPI

Thomas Benjamin Meeusen, PT

  • Physical Therapist
  • Fredericksburg, VA
National Provider Identifier
1902321839
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305211342 Issued in VA
Practice address
4701 Spotsylvania Pkwy Ste 106
Fredericksburg, VA 22407-9435
Phone
(540) 710-0100
NPI assigned
Aug 11, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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 2305211342 VA Primary

Addresses

Primary practice location

4701 Spotsylvania Pkwy Ste 106
Fredericksburg, VA 22407-9435

Mailing address

4701 Spotsylvania Pkwy
Ste 106
Fredericksburg, VA 22407-9435

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171208001902 DC Practitioner - Physical Therapist in Private Practice 5496012973 Reassigns benefits to 1 organization
I20200304002761 VA Practitioner - Physical Therapist in Private Practice 5496012973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proflex Physical Therapy of Maryland, LLCGroup PAC ID 7416244322, 41 clinicians

Practice addresses (Care Compare)

616 Garrisonville Rd
Stafford, VA 22554-3707
Phone (540) 628-4612

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305211342VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Performance Physical Therapy,LLC Physical Therapist CurrentSince Dec 27, 2017 Accepting new patients
Proflex Physical Thearpy of Maryland, LLC CurrentSince Apr 5, 2023 Accepting new patients
Proflex Physical Therapy of Maryland, LLC. Physical Therapist CurrentSince Apr 5, 2023 Accepting new patients

Locations

7700B Gunston Plz
Lorton, VA 22079
Phone (703) 263-2020

2777 Richmond Hwy
Ste 109
Stafford, VA 22554
Phone (540) 318-8615

616 Garrisonville Rd
Stafford, VA 22554
Phone (540) 628-4612

Organizations & group practices 3

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": "1502409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1902321839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 SPOTSYLVANIA PKWY",
            "address_2": "STE 106",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224079435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 SPOTSYLVANIA PKWY STE 106",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224079435",
            "telephone_number": "540-710-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEEUSEN",
        "first_name": "THOMAS",
        "middle_name": "BENJAMIN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-11",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305211342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; 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.