Patapsco Health & Rehab LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

PATAPSCO HEALTH & REHAB LLC

Practice address

8975 Guilford Rd Ste 170
Columbia, MD 21046-2389

Phone

(410) 705-5541

NPI assigned

Jun 4, 2020

Organization subpart

No

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

Authorized official

Name

Jamiel Sharief HafizNPI 1730201773

Title

Managing Employee W-2

Phone

(410) 227-4939

Specialties & licenses 8

Addresses

Other names 1

• Patapsco Integrative Medicine & Rehab Doing business as

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jamiel Sharief Hafiz, LPA, LAC

  • Medical Physician Assistant
  • Ellicott City, MD
  • NPI 1730201773
  Medicare reassignment Care Compare group Authorized official
• Michelle Yentsch, OTR/L

  • Occupational Therapist
  • Catonsville, MD
  • NPI 1154083269
  Medicare reassignment Care Compare group NPD
• Dushyant Viswanathan, M.D.

  • Internal Medicine Physician
  • Woodland Hills, CA
  • NPI 1285897421

  MD, Multi-Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1591228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676160000000",
    "number": "1982228045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 STONE SPRING CT",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212285367",
            "telephone_number": "410-227-4939",
            "fax_number": "769-201-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8975 GUILFORD RD STE 170",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210462389",
            "telephone_number": "410-705-5541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9020 Old Georgetown Rd",
            "address_purpose": "LOCATION",
            "city": "Bethesda",
            "state": "MD",
            "postal_code": "208141514",
            "country_code": "US",
            "telephone_number": "410-705-5541",
            "fax_number": "769-201-0777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7226 Lee DeForest Dr Ste 204",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MD",
            "postal_code": "210463238",
            "country_code": "US",
            "telephone_number": "410-705-5541",
            "fax_number": "769-201-0777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PATAPSCO HEALTH & REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-04",
        "last_updated": "2023-02-12",
        "certification_date": "2023-02-12",
        "status": "A",
        "authorized_official_last_name": "HAFIZ",
        "authorized_official_first_name": "JAMIEL",
        "authorized_official_middle_name": "SHARIEF",
        "authorized_official_title_or_position": "MANAGING EMPLOYEE W-2",
        "authorized_official_telephone_number": "410-227-4939"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Patapsco Integrative Medicine & Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Passport Health Holdings, LLC
• Diana Lynn Passwaters, CRNP
• Michelle Renee Pasternack, CCSW C
• Patapsco Eye MDS, LLC
• Patapsco Family Psychiatry LLC
• Dharti P. Patel Christo
• Aaliyna Chaitanya Patel
• Alkesh Patel, M.D.
• Ami Patel, PHARM.D.
• Bhargav Patel

• Multi-Specialty Clinic/Center in Columbia, MD
• Providers in Columbia, MD by specialty
• Multi-Specialty Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.