Individual provider Active NPI

Marc D Levine, RPT

  • Contractor
  • Valencia, CA
National Provider Identifier
1003949249
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
PT 16807 Issued in CA
Practice address
23356 Timberlane Dr
Valencia, CA 91354-1450
Phone
(661) 513-9317
Fax
(661) 513-9348
NPI assigned
Mar 14, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X PT 16807 CA Primary

Addresses

Primary practice location

23356 Timberlane Dr
Valencia, CA 91354-1450

Mailing address

23356 Timberlane Dr
Valencia, CA 91354-1450
Phone (661) 513-9317

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040312000706 CA Practitioner - Physical Therapist in Private Practice 3779472493 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1990
Medicare assignment
May accept Medicare assignment
Group practices
Relief Physical Therapy IncGroup PAC ID 9234163809, 2 clinicians

Practice addresses (Care Compare)

23356 Timberlane Dr
Valencia, CA 91354-1450
Phone (323) 899-4266

27225 Camp Plenty Rd
Suite 6
Canyon Country, CA 91351-2654
Phone (661) 298-0140

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16807CAMDClinical Psychologist
PT 16807CAMDContractor

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003949249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23356 TIMBERLANE DR",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913541450",
            "telephone_number": "661-513-9317",
            "fax_number": "661-513-9348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23356 TIMBERLANE DR",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913541450",
            "telephone_number": "661-513-9317",
            "fax_number": "661-513-9348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVINE",
        "first_name": "MARC",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "RPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "CA",
            "license": "PT 16807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valencia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.