Individual provider Active NPI

James Poenitzsch, PT, DPT, COMT, CSCS

  • Physical Therapist
  • Manvel, TX
National Provider Identifier
1003357617
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1278358 Issued in TX
Practice address
11540 Magnolia Pkwy Ste G
Manvel, TX 77578-1649
Phone
(281) 213-0642
Fax
(281) 213-0324
NPI assigned
Mar 15, 2017
Last updated
Feb 1, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

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 1278358 TX Primary

Addresses

Primary practice location

11540 Magnolia Pkwy Ste G
Manvel, TX 77578-1649

Mailing address

12916 Southern Valley Dr
Pearland, TX 77584-3690
Phone (979) 253-0360

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170512000543 TX Practitioner - Physical Therapist in Private Practice 6406133875 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Live to Move, LLCGroup PAC ID 3375887250, 4 clinicians

Practice addresses (Care Compare)

11540 Magnolia Pkwy
Suite G
Manvel, TX 77578-1649
Phone (281) 213-0642

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1278358TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Live to Move LLC Physical Therapist CurrentSince Mar 12, 2018 Accepting new patients
All Things Maternal Physical Therapy LLC Physical Therapist PastSince Sep 5, 2023 Accepting new patients

Locations

11540 Magnolia Pkwy
Ste G
Manvel, TX 77578
Phone (281) 213-0642

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": "1489536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1003357617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12916 SOUTHERN VALLEY DR",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775843690",
            "telephone_number": "979-253-0360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11540 MAGNOLIA PKWY STE G",
            "city": "MANVEL",
            "state": "TX",
            "postal_code": "775781649",
            "telephone_number": "281-213-0642",
            "fax_number": "281-213-0324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POENITZSCH",
        "first_name": "JAMES",
        "credential": "PT, DPT, COMT, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-15",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1278358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manvel, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; 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.