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
- 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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ati Holding LLC | Multi-Specialty | Past | Accepting new patients |
| Ati Holdings, 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 and National Provider Directory roles.
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.