Individual provider Active NPI

Mariah Bertrand

  • Physical Therapist
  • Rockwall, TX
National Provider Identifier
1053018440
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
2268 N Lake Shore Dr Ste 106
Rockwall, TX 75087-0280
Phone
(972) 979-6577
NPI assigned
Feb 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1383320 TX
Physical Therapist 225100000X Primary

Addresses

Primary practice location

2268 N Lake Shore Dr Ste 106
Rockwall, TX 75087-0280

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (866) 370-8206

Other practice location 1

10767 Carol Lynn Rd
Denham Springs, LA 70726-1665
Phone (866) 370-8206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230404001825 NM Practitioner - Physical Therapist in Private Practice 7618342684 Reassigns benefits to 1 organization
I20230920004301 TX Practitioner - Physical Therapist in Private Practice 7618342684 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ideal Physical Therapy of Texas LLCGroup PAC ID 0547583809, 359 clinicians

Practice addresses (Care Compare)

2360 W Camp Wisdom Rd
Suite 140
Grand Prairie, TX 75052-2216
Phone (469) 460-6683

Merit-based Incentive Payment System (MIPS)

Final score
85.56 of 100Reported as group
Quality
89.48
Improvement activities
40
Cost
71.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Physical Therapy of Texas LLC Physical Therapist CurrentSince Sep 4, 2023 Accepting new patients
Ideal Physical Therapy of Texas LLC CurrentSince Sep 4, 2023 Accepting new patients
Physical Therapy at Dawn, LLC Physical Therapist CurrentSince Mar 20, 2023 Accepting new patients

Locations (25 of 29)

790 Remington Blvd
Bolingbrook, IL 60440

6330 Riverside Plaza Ln NW
Albuquerque, NM 87120
Phone (505) 312-7930

6330 Riverside Plaza Ln NW
Ste 150
Albuquerque, NM 87120
Phone (505) 312-7930

3611 NM 528 NW
Ste 101
Albuquerque, NM 87114
Phone (505) 217-2826

17051 Dallas Pkwy
Ste 450
Addison, TX 75001
Phone (214) 272-8561

5335 W Sublett Rd
Ste 151
Arlington, TX 76017
Phone (817) 839-9150

1827 SW Green Oaks Blvd
Ste 143
Arlington, TX 76017
Phone (512) 501-4783

4100 Fairway Dr
Ste 400
Carrollton, TX 75010
Phone (972) 394-3325

379 E FM 1382
Ste 100
Cedar Hill, TX 75104
Phone (972) 460-4490

106 N Denton Tap Rd
Ste 220
Coppell, TX 75019
Phone (469) 528-6437

6029 Forest Ln
Dallas, TX 75230
Phone (469) 872-7548

12747 Midway Rd
Ste 150
Dallas, TX 75244
Phone (469) 872-4562

9660 Audelia Rd
Ste 101
Dallas, TX 75238
Phone (214) 273-0510

14999 Preston Rd
Ste 108C
Dallas, TX 75254
Phone (214) 231-4154

607 S Cedar Ridge Dr
Unit 102
Duncanville, TX 75137
Phone (214) 742-8560

1540 Eastchase Pkwy
Ste 4A
Fort Worth, TX 76120

2600 W 7th St
Ste 137
Fort Worth, TX 76107
Phone (682) 233-6462

8845 Gary Burns Dr
Ste 100
Frisco, TX 75034
Phone (469) 403-2090

1215 W Pioneer Pkwy
Ste 200
Grand Prairie, TX 75051
Phone (972) 400-4752

2360 W Camp Wisdom Rd
Ste 140
Grand Prairie, TX 75052
Phone (469) 460-6683

6420 N MacArthur Blvd
Ste 130
Irving, TX 75039
Phone (972) 402-8300

3141 E Broad St
Ste 111
Mansfield, TX 76063
Phone (817) 435-5248

410 W FM 544
Ste 105
Murphy, TX 75094
Phone (469) 606-5003

308 Coit Rd
Ste 400
Plano, TX 75075
Phone (469) 573-9606

4709 W Parker Rd
Ste 460
Plano, TX 75093
Phone (469) 440-5420

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": "1676419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1053018440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "866-370-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2268 N LAKE SHORE DR STE 106",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750870280",
            "telephone_number": "972-979-6577"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10767 Carol Lynn Rd",
            "address_purpose": "LOCATION",
            "city": "Denham Springs",
            "state": "LA",
            "postal_code": "707261665",
            "country_code": "US",
            "telephone_number": "866-370-8206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERTRAND",
        "first_name": "MARIAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-15",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1383320",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockwall, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; 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.