Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Kenneth Jana Nolasco, PT, DPT

Individual provider Physical Therapist · NPI 1619862430

Dr. Kenneth Jana Nolasco, PT, DPT is a Physical Therapist in Private Practice in Nottingham, Maryland. Graduated from University of Maryland School of Medicine in 2025, 1 year ago. Practices with Active Life and Sports Therapy LLC, a 10-clinician group and accepts Medicare assignment. Licensed in Maryland.

Years since qualifying
1
Trained at
University of Maryland School of Medicine
Licensed in
MD
In the registry since
2025
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

4337 Ebenezer Rd
Nottingham, MD 21236-2143
Phone: (410) 529-3303
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 30423 (MD)

Record details

NPI number1619862430
Entity typeIndividual (Type 1)
GenderMale
Credentials PT , DPT
Sole proprietorNo
NPI enumeratedJune 11, 2025
Last updated in NPPESJuly 7, 2025
Certification dateJuly 7, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolUNIVERSITY OF MARYLAND SCHOOL OF MEDICINE
Graduated 2025 (1 years in practice)
Group practice Active Life And Sports Therapy Llc — 10 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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