Maxwell Blake (NPI# 1023597382, PAC ID# 0042560708) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL THERAPY.
| Nation Provider ID (NPI) | 1023597382 |
| PAC ID by PECOS | 0042560708 |
| Professional Enrollment ID | I20180830002190 |
| Full Name | Maxwell Blake |
| Organization Legal Name | PROFESSIONAL SPORTSCARE AND REHAB LLC |
| Address |
1600 Wilson Blvd Suite 102 Arlington VA 22209-2505 |
| Phone Number | 7039351996 |
| Gender | M |
| Medical School | UNIVERSITY OF VERMONT COLLEGE OF MEDICINE |
| Graduation Year | 2018 |
| Primary Specialty | PHYSICAL THERAPY |
| Group Practice PAC ID | 9335137363 |
| Number of Group Practice Members | 87 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 1600 Wilson Blvd, Suite 102, Arlington, VA 22209-2505 | 7039351996 | PROFESSIONAL SPORTSCARE AND REHAB LLC |
| Organization Legal Name | PROFESSIONAL SPORTSCARE AND REHAB LLC |
| Physicians | 114 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ashleigh Demel | Physical Therapy | Professional Sportscare and Rehab LLC | 3508 Connecticut Ave Nw, Washington, DC 20008-2401 |
| Brennon Monroe | Physical Therapy | Professional Sportscare and Rehab LLC | 1150 18th St Nw, Suite Ll4, Washington, DC 20036-3839 |
| Julie Trinchere | Physical Therapy | Professional Sportscare and Rehab LLC | 10940 Fairfax Blvd, Fairfax, VA 22030-4301 |
| Nishit Panjwani | Physical Therapy | Professional Sportscare and Rehab LLC | 502 W Broad St, Suite 103, Falls Church, VA 22046-3204 |
| Elisabeth Kim | Physical Therapy | Professional Sportscare and Rehab LLC | 11662 Sudley Manor Dr, 50b, Manassas, VA 20109-2842 |
| Kevin William Faust | Physical Therapy | Professional Sportscare and Rehab LLC | 21453 Epicerie Plz, Suite 100, Sterling, VA 20164-6648 |
| Jeffrey S Botta | Physical Therapy | Professional Sportscare and Rehab LLC | 7223 Commerce St, Suite 40, Springfield, VA 22150-3411 |
| Amber Leigh Harrison | Physical Therapy | Professional Sportscare and Rehab LLC | 6444 Trading Sq, Suite 50, Haymarket, VA 20169-2277 |
| Katie E Thompson | Physical Therapy | Professional Sportscare and Rehab LLC | 210 Fort Evans Rd Ne, Suite B, Leesburg, VA 20176-4497 |
| Danielle Leshinsky | Physical Therapy | Professional Sportscare and Rehab LLC | 1010 Wayne Ave, Suite 110, Silver Spring, MD 20910-5627 |
| Street Address |
1600 WILSON BLVD SUITE 102 |
| City | ARLINGTON |
| State | VA |
| Zip | 22209-2505 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Wilfried Sansfaute | Chiropractic | 1600 Wilson Blvd, Suite 320, Arlington, VA 22209-2510 | |
| Sheila Ramsey | Clinical Social Worker | 1600 Wilson Blvd, Suite 702 Rosslyn Va, Arlington, VA 22209-2505 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David Weiss | Optometry | 1700 N Moore St, Suite 300, Arlington, VA 22209-1903 | |
| Kerry A Mimberg | Physical Therapy | Optimal Physical Therapy LLC | 1700 N Moore St, Suite 1925, Arlington, VA 22209-1916 |
| Melissa A Pietraszewski | Physical Therapy | Optimal Physical Therapy LLC | 1700 N Moore St, Suite 1925, Arlington, VA 22209-1916 |
| Alexandra C Stewart | Physician Assistant | Skindc Pllc | 1525 Wilson Blvd, Suite 125, Arlington, VA 22209-2411 |
| Lina I Naga | Dermatology | Skindc Pllc | 1525 Wilson Blvd, Suite 125, Arlington, VA 22209-2411 |
| Jacqueline M Bourassa | Physician Assistant | Skindc Pllc | 1525 Wilson Blvd, Suite 125, Arlington, VA 22209-2411 |
| Mary E Walterhoefer | Dermatology | Skindc Pllc | 1525 Wilson Blvd, Suite 125, Arlington, VA 22209-2411 |
| Terrence C Keaney | Dermatology | Skindc Pllc | 1525 Wilson Blvd, Suite 125, Arlington, VA 22209-2411 |
| Lonnie D Davis | Orthopedic Surgery | 1701 Clarendon Blvd, Suite 120, Arlington, VA 22209-2700 |
| City | ARLINGTON |
| Zip Code | 22209 |
| Specialty | PHYSICAL THERAPY |
| City + Specialty | ARLINGTON + PHYSICAL THERAPY |
Please comment or provide details below to improve the information on Maxwell Blake.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.