Individual provider Active NPI

Amanda Marie Beal, DPT

  • Physical Therapist
  • Annapolis, MD
National Provider Identifier
1992814578
Registry record updated Jun 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
21554 Issued in MD
Practice address
901 Commerce Rd
Annapolis, MD 21401-2944
Phone
(410) 224-2626
NPI assigned
Aug 29, 2006
Last updated
Jun 20, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 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 21554 MD Primary

Addresses

Primary practice location

901 Commerce Rd
Annapolis, MD 21401-2944

Mailing address

10300B Baltimore National Pike
Ellicott City, MD 21042-2128
Phone (410) 998-5171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080926000011 MD Practitioner - Physical Therapist in Private Practice 3375610710 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Revive Physical Therapy LLCGroup PAC ID 0547427627, 6 clinicians

Practice addresses (Care Compare)

10300 Baltimore National Pike
B
Ellicott City, MD 21042-2128
Phone (410) 988-5171

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Revive Physical Therapy LLC CurrentSince Aug 20, 2018 Accepting new patients
Physiotherapy Associates Inc Past Accepting new patients

Locations

10300 Baltimore National Pike
#B
Ellicott City, MD 21042
Phone (410) 988-5171

10300 Baltimore National Pike
#Pb
Ellicott City, MD 21042
Phone (410) 988-5171

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.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560988800000",
    "number": "1992814578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10300B BALTIMORE NATIONAL PIKE",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210422128",
            "telephone_number": "410-998-5171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 COMMERCE RD",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214012944",
            "telephone_number": "410-224-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAL",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2019-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "21554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.