Physical Medicine Ctr of Marin, a PT Corp.

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PHYSICAL MEDICINE CTR OF MARIN, A PT CORP.

Practice address

33 Miller Ave
Mill Valley, CA 94941-1903

Phone

(415) 380-9242

Fax

(415) 388-7458

NPI assigned

Jun 6, 2008

Organization subpart

No

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

Authorized official

Name

Michael Joseph Iacovelli, PT, DCNPI 1831200872

Title

President, Physical Therapist

Phone

(415) 380-9242

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Joseph Iacovelli, PT

  • Physical Therapist
  • Mill Valley, CA
  • NPI 1831200872
  Medicare reassignment Care Compare group NPD Authorized official
• Lisa Sharon Iacovelli, PT

  • Physical Therapist
  • Mill Valley, CA
  • NPI 1093826026
  Medicare reassignment Care Compare group NPD
• Rosemaria Schumann, PT

  • Physical Therapist
  • Mill Valley, CA
  • NPI 1952646317
  NPD (past)

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

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212710400000",
    "number": "1013176775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 MILLER AVE",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949411903",
            "telephone_number": "415-380-9242",
            "fax_number": "415-388-7458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 MILLER AVE",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949411903",
            "telephone_number": "415-380-9242",
            "fax_number": "415-388-7458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL MEDICINE CTR OF MARIN, A PT CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-06",
        "last_updated": "2008-06-06",
        "status": "A",
        "authorized_official_last_name": "IACOVELLI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT, PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "415-380-9242",
        "authorized_official_credential": "PT, DC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Peters, N.P.
• Catherine Pham
• Pharmaca Integrative Pharmacy, Inc.
• Andrew Phong, DPT, PT
• Chalita Photikoe, LAC
• Ellen Lois Pichey, M.D.
• Julie Lynn Pies, PTA,LMT,MFRP
• Platt Marriage & Family Therapy Corporation
• Platt Marriage and Family Therapy Corporation
• Mark John Poggetti, P.T., D.P.T.

• Physical Therapist in Mill Valley, CA
• Providers in Mill Valley, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.