Nathaniel Adrian Mascarenas, DPT, OCS

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

PT5111 Issued in NM

Practice address

1501 San Pedro Dr SE
Albuquerque, NM 87108-5153

Phone

(505) 265-1711

NPI assigned

Sep 18, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1053199372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 JEFFERSON ST NE APT 39",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871081278",
            "telephone_number": "505-720-0570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 SAN PEDRO DR SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871085153",
            "telephone_number": "505-265-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASCARENAS",
        "first_name": "NATHANIEL",
        "middle_name": "ADRIAN",
        "name_prefix": "Dr.",
        "credential": "DPT,  OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NM",
            "license": "PT5111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Marzullo, MPA
• Loretta Monique Mascarenas-Benavidez
• Joleen Mascarenas-Marlow
• Marcos Mascarenas
• Maya Mascarenas
• Yvette A Mascarenas, RD
• Renee Masker Edwards, SLP
• Nicole Masker, OTD
• Lauren Maslen
• Andrew Mason, M.D.

• Orthopedic Physical Therapist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Orthopedic Physical Therapist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.