Active NPI
Maria Soledad C. Lalic, PT
- Physical Therapist
- Waldorf, MD
National Provider Identifier
1992137657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- P12892
- Practice address
- 3018 Festival Way # 323
Waldorf, MD 20601-2958 - Phone
- (240) 754-5520
- Fax
- (301) 705-6797
- NPI assigned
- Aug 5, 2013
- Last updated
- Apr 24, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | P12892 | NC | Primary |
| Physical Therapist | 225100000X | 26924 | MD |
Addresses
Primary practice location
3018 Festival Way # 323
Waldorf, MD 20601-2958
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2222
Other names 1
- Maria Soledad L. Delos Reyes
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26924 | MD | MD | Physical Therapist |
| P12892 | NC | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ati Holdings, LLC | Multi-Specialty | Past | Accepting new patients |
| Ati Holding LLC | Multi-Specialty | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba ATI Physical Therapy
- Physical Therapist
- Waldorf, MD
- NPI 1437634250
Multi-Specialty
-
dba ATI Physical Therapy Waldorf
- Physical Therapist
- Waldorf, MD
- NPI 1215319041
Multi-Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556064000000",
"number": "1992137657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909",
"telephone_number": "630-296-2222",
"fax_number": "630-759-9510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3018 FESTIVAL WAY # 323",
"city": "WALDORF",
"state": "MD",
"postal_code": "206012958",
"telephone_number": "240-754-5520",
"fax_number": "301-705-6797"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LALIC",
"first_name": "MARIA SOLEDAD",
"middle_name": "C.",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-08-05",
"last_updated": "2019-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "P12892",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "MD",
"license": "26924",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARIA SOLEDAD",
"last_name": "DELOS REYES",
"middle_name": "L.",
"credential": "PT",
"code": "1",
"type": "Former Name"
}
]
}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 Apr 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.