Dara Faye Gonzales Alicando, PT – Physical Therapist

Key facts

NPI: 1962068254
Entity type: Individual (NPI type 1)
Primary specialty: Physical Therapist 225100000X
License: 22877 (MD)
Practice address: 12230 Roundwood Rd
Timonium, MD 21093-3233
Phone: (410) 252-0880
Fax: (443) 632-0690
NPI assigned: May 13, 2019
Sex: Female
Sole proprietor: No

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.

LHMG Physical Therapy, LLC Physical Therapy Clinic/Center · Annapolis, MD · NPI 1396122842

Medicare reassignment NPD MD · PHYSICAL THERAPIST
LHMG Physical Therapy, LLC Physical Therapist · Annapolis, MD · NPI 1134763212

NPD PHYSICAL THERAPIST

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MD

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20231214000031	MD	Practitioner - Physical Therapist in Private Practice	9335504760	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
22877	MD	MD	Physical Therapist

Practice roles

Organization	Specialty	Status	New patients
LHMG Physical Therapy, LLC	Physical Therapist	Current	Accepting new patients
LHMG Physical Therapy, LLC	Physical Therapist	Current since Oct 24, 2024	Accepting new patients

Locations

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

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

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Physical Therapist	225100000X	22877	MD	Yes

Addresses

Primary practice location

12230 Roundwood Rd
Timonium, MD 21093-3233

Mailing address

20 Tilton CT
Nottingham, MD 21236-5183
Phone (443) 844-6789

Other providers in Timonium, MD

All providers in Timonium, MD · Physical Therapist in Maryland

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 13, 2019. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider 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.