Legacy Physiatry Group Maryland, LLC
NPI 1669869939ActiveOrganization· Physical Medicine & Rehabilitation· Gaithersburg, MD
Physical Medicine & Rehabilitation in Gaithersburg, Maryland, registered in NPPES in April 2015. The authorized official on file is Marilyn J. Mearon, Billing Manager. Enrolled in Medicare as part b supplier - clinic/group practice and part b supplier - clinic/group practice.
Overview
| NPI | 1669869939 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 23, 2015 |
| Last updated in NPPES | Oct 27, 2023 |
| Certified by provider | Oct 27, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Medicine & Rehabilitation Primary | 208100000X | — | — |
| Internal Medicine | 207R00000X | — | — |
| Physician Assistant | 363A00000X | — | — |
| Nurse Practitioner | 363L00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (DC); Part B Supplier - Clinic/Group Practice (MD) |
|---|
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