Individual provider Active NPI

Carl Joshua C Camarillo, DPT

  • Physical Therapist
  • Waldorf, MD
National Provider Identifier
1902409238
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
28152 Issued in MD
Practice address
3084 Waldorf Market PL
Waldorf, MD 20603-4872
Phone
(240) 530-8188
Fax
(301) 638-0470
NPI assigned
Nov 19, 2020
Last updated
Mar 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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 28152 MD Primary

Addresses

Primary practice location

3084 Waldorf Market PL
Waldorf, MD 20603-4872

Mailing address

3084 Waldorf Market PL
Waldorf, MD 20603-4872
Phone (240) 530-8188

Other practice location 1

4255 Altamont Pl Ste 201
White Plains, MD 20695-3024
Phone (301) 645-8020

Other practice location 2

4467 Old Branch Ave Ste 103
Temple Hills, MD 20748-1854
Phone (301) 358-6155

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221220000762 MD Practitioner - Physical Therapist in Private Practice 5799154449 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

23415 Three Notch Rd
Suite 2026
California, MD 20619-4021
Phone (240) 530-8188

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Centers for Advanced Orthopaedics, LLC CurrentSince Mar 17, 2025 Accepting new patients
Centers for Advanced Orthopaedics, LLC Current Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Mar 17, 2025 Accepting new patients
Sports Physical Therapy of Towson, P.a. Physical Therapist PastSince Oct 1, 1994 Accepting new patients

Locations

23415 Three Notch Rd
Ste 2026
California, MD 20619
Phone (240) 530-8188

86 Thomas Johnson Ct
Frederick, MD 21702
Phone (301) 607-0444

3084 Waldorf Market Pl
Waldorf, MD 20603
Phone (240) 530-8188

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1605744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1902409238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3084 WALDORF MARKET PL",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034872",
            "telephone_number": "240-530-8188",
            "fax_number": "301-638-0470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3084 WALDORF MARKET PL",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034872",
            "telephone_number": "240-530-8188",
            "fax_number": "301-638-0470"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4255 Altamont Pl Ste 201",
            "address_purpose": "LOCATION",
            "city": "White Plains",
            "state": "MD",
            "postal_code": "206953024",
            "country_code": "US",
            "telephone_number": "301-645-8020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4467 Old Branch Ave Ste 103",
            "address_purpose": "LOCATION",
            "city": "Temple Hills",
            "state": "MD",
            "postal_code": "207481854",
            "country_code": "US",
            "telephone_number": "301-358-6155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMARILLO",
        "first_name": "CARL",
        "middle_name": "JOSHUA C",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-19",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "28152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; 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.