Individual provider Active NPI

Mark Fhil Quintana Monton, PT

  • Physical Therapist
  • Livonia, MI
National Provider Identifier
1033405964
Registry record updated Jun 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501015583 Issued in MI
Practice address
14555 Levan Rd Ste 215
Livonia, MI 48154-5085
Phone
(734) 542-9770
NPI assigned
Jun 20, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2011

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 5501015583 MI Primary

Addresses

Primary practice location

14555 Levan Rd Ste 215
Livonia, MI 48154-5085

Mailing address

6919 Pittsford St
Canton, MI 48187-2727
Phone (734) 709-0187

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110816000334 MI Practitioner - Physical Therapist in Private Practice 4385813922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mendelson Orthopedics PCGroup PAC ID 8426008368, 69 clinicians

Practice addresses (Care Compare)

36622 5 Mile Rd
Livonia, MI 48154-1900
Phone (734) 542-0200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501015583MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mendelson Orthopedics PC CurrentSince Jun 22, 2011 Accepting new patients
Mendelson Orthopedics PC CurrentSince Jun 22, 2011 Accepting new patients
Mendelson Orthopedics PC Past Accepting new patients

Locations

36622 5 Mile Rd
Ste 102
Livonia, MI 48154
Phone (734) 542-9770

14555 Levan Rd
Ste 215
Livonia, MI 48154
Phone (734) 542-0200

36622 5 Mile Rd
Livonia, MI 48154
Phone (734) 542-0200

27472 Schoenherr Rd
Ste 140
Warren, MI 48088
Phone (586) 439-6242

Organizations & group practices 3

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": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308528000000",
    "number": "1033405964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6919 PITTSFORD ST",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481872727",
            "telephone_number": "734-709-0187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14555 LEVAN RD STE 215",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481545085",
            "telephone_number": "734-542-9770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTON",
        "first_name": "MARK FHIL",
        "middle_name": "QUINTANA",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-20",
        "last_updated": "2011-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501015583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2011; 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.