NPIMap

Individual provider Active NPI

Anthony Brandon Bagley, PT , DPT

  • Physical Therapist
  • Hyattsville, MD
National Provider Identifier
1932733219
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
27873 Issued in MD
Practice address
1535 University Blvd E Ste D
Hyattsville, MD 20783-4694
Phone
(301) 434-1850
NPI assigned
Feb 26, 2020
Last updated
Feb 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU
Physical Therapist 225100000X 27873 MD Primary

Addresses

Primary practice location

1535 University Blvd E Ste D
Hyattsville, MD 20783-4694

Mailing address

14603 Donegal CT
Bowie, MD 20721-3229
Phone (301) 518-2553

Other practice location 1

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

Other practice location 2

4483 Forbes Blvd Ste A
Lanham, MD 20706-4377
Phone (240) 467-5732

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200610000001 DC Practitioner - Physical Therapist in Private Practice 2567883051 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27873MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mosaddegh Physical Therapy Inc Physical Therapist CurrentSince May 23, 2022 Accepting new patients
Fox Rehabilitation Services LLC Physical Therapist CurrentSince Mar 1, 2021 Accepting new patients
Active Physical Therapy Services, LLC Physical Therapist PastSince Feb 12, 2023 Accepting new patients
Mosaddegh Physical Therapy Inc. Physical Therapist PastSince Oct 13, 2019 Accepting new patients

Locations

7500 Hanover Pkwy
Ste 103
Greenbelt, MD 20770
Phone (301) 446-1644

17902 Georgia Ave
Ste 100
Olney, MD 20832
Phone (301) 260-8383

17902 Georgia Ave
Ste 220
Olney, MD 20832

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": "1582675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1932733219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14603 DONEGAL CT",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207213229",
            "telephone_number": "301-518-2553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 UNIVERSITY BLVD E STE D",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207834694",
            "telephone_number": "301-434-1850"
        }
    ],
    "practiceLocations": [
        {
            "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"
        },
        {
            "address_1": "4483 Forbes Blvd Ste A",
            "address_purpose": "LOCATION",
            "city": "Lanham",
            "state": "MD",
            "postal_code": "207064377",
            "country_code": "US",
            "telephone_number": "240-467-5732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAGLEY",
        "first_name": "ANTHONY",
        "middle_name": "BRANDON",
        "name_prefix": "Dr.",
        "credential": "PT , DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-26",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "27873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyattsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; 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.