Individual provider Active NPI

Deniese Earlene Brock, PT

  • Physical Therapist
  • Bel Air, MD
National Provider Identifier
1952383077
Registry record updated Jan 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
24520 Issued in MD
Practice address
2225 Old Emmorton Rd Ste 210
Bel Air, MD 21015-6123
Phone
(410) 569-0990
Fax
(410) 515-0777
NPI assigned
Nov 15, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2019

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 24520 MD Primary

Addresses

Primary practice location

2225 Old Emmorton Rd Ste 210
Bel Air, MD 21015-6123

Mailing address

7403 Brixworth CT Unit 101
Windsor Mill, MD 21244-5670
Phone (302) 750-1785

Other identifiers 1

IdentifierTypeStateIssuer
0000041626MedicaidDE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241125000295 DC Practitioner - Physical Therapist in Private Practice 8628503950 Reassigns benefits to 1 organization
I20241206000021 MD Practitioner - Physical Therapist in Private Practice 8628503950 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Health Physical Therapy at Home LLCGroup PAC ID 7012379134, 15 clinicians
Maryland Luna Care Physical Therapy LLCGroup PAC ID 4284017419, 123 clinicians

Practice addresses (Care Compare)

Columbia, MD 21044
Phone (301) 540-6140

5425 Wisconsin Ave
Suite 600
Chevy Chase, MD 20815-3588
Phone (866) 525-3175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24520MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Health Physical Therapy at Home, LLC. Physical Therapist CurrentSince Nov 13, 2024 Accepting new patients
LHMG Physical Therapy, LLC Physical Therapist Current Accepting new patients
LHMG Physical Therapy, LLC Physical Therapist CurrentSince Nov 13, 2024 Accepting new patients
Maryland Luna Care Physical Therapy LLC Physical Therapist CurrentSince Nov 13, 2024 Accepting new patients
Medstar Health Physical Therapy at Home, LLC. Physical Therapist CurrentSince Nov 13, 2024 Accepting new patients
LHMG Physical Therapy, LLC Physical Therapist CurrentSince Nov 13, 2024 Accepting new patients
The Maryland Therapy Network, Inc Physical Therapist Past Accepting new patients

Locations

5425 Wisconsin Ave
Ste 600
Chevy Chase, MD 20815
Phone (202) 223-3077

10980 Grantchester Way
Columbia, MD 21044
Phone (301) 202-1073

1106 Annapolis Rd
Ste 120
Odenton, MD 21113
Phone (410) 674-1650

8109 Ritchie Hwy
Ste 600
Pasadena, MD 21122
Phone (410) 553-3515

Organizations & group practices 7

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": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548288000000",
    "number": "1952383077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7403 BRIXWORTH CT UNIT 101",
            "city": "WINDSOR MILL",
            "state": "MD",
            "postal_code": "212445670",
            "telephone_number": "302-750-1785",
            "fax_number": "443-316-8641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 OLD EMMORTON RD STE 210",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210156123",
            "telephone_number": "410-569-0990",
            "fax_number": "410-515-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "DENIESE",
        "middle_name": "EARLENE",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-15",
        "last_updated": "2019-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "24520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000041626",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2019; 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.