Mark Mako, P.T., O.C.S.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 15347 Issued in CA

Practice address

2585 Cochran St
Suite a
Simi Valley, CA 93065-2602

Phone

(805) 584-0001

Fax

(805) 527-9135

NPI assigned

May 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Body Mechanix Physical Therapy Inc 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Body Mechanix Physical Therapy Inc

  • Physical Therapist
  • Simi Valley, CA
  • NPI 1831143031

  CA, Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190246400000",
    "number": "1013961275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2585 COCHRAN ST",
            "address_2": "SUITE A",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930652602",
            "telephone_number": "805-584-0001",
            "fax_number": "805-527-9135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2585 COCHRAN ST",
            "address_2": "SUITE A",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930652602",
            "telephone_number": "805-584-0001",
            "fax_number": "805-527-9135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKO",
        "first_name": "MARK",
        "credential": "P.T., O.C.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2007-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 15347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "77057605493065A002",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF CA",
            "identifier": "PT00015347",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "0PT153470",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jane A Maiello, D.D.S
• Ralph J Maiello, DDS
• Maximilian Thomas Mair
• Tony Makhlouf, MD
• Mojgan Makhsoosi, M.D. INC.
• John Daniel Malan, AUD
• Malini Soogoor, M.D. Inc
• Leeann Mallari
• Mama Cher Doula Services LLC
• Vhumbani Mancilla, BCBA

• All providers in Simi Valley, CA
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.