Individual provider Active NPI

Mark S Decarlo, PT

  • Physical Therapist
  • Carmel, IN
National Provider Identifier
1083811749
Registry record updated Apr 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
050018551 Issued in IN
Practice address
12955 Old Meridian St Ste 101
Carmel, IN 46032-7100
Phone
(317) 819-6600
Fax
(317) 819-6601
NPI assigned
Jun 27, 2007
Last updated
Apr 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2018

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 050018551 IN Primary

Addresses

Primary practice location

12955 Old Meridian St Ste 101
Carmel, IN 46032-7100

Mailing address

33900 Harper Ave Ste 104
Clinton TWP, MI 48035-4258
Phone (586) 350-2644

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101123000247 IN Practitioner - Physical Therapist in Private Practice 1759285042 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

12505 Old Meridian St
Suite 150
Carmel, IN 46032-8849
Phone (317) 819-9500

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
050018551INMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Sep 5, 2023 Accepting new patients
Team Rehabilitation Services, LLC Physical Therapist CurrentSince Oct 25, 2021 Accepting new patients
Athletico, LTD Physical Therapist CurrentSince Sep 5, 2023 Accepting new patients
Team Rehabilitation Services, LLC Physical Therapist CurrentSince Oct 25, 2021 Accepting new patients
Athletico LTD Physical Therapist Current Accepting new patients

Locations

12505 Old Meridian St
Ste 150
Carmel, IN 46032
Phone (317) 819-9500

12955 Old Meridian St
Ste 101
Carmel, IN 46032
Phone (317) 819-6600

9885 E 116th St
Ste 400
Fishers, IN 46037
Phone (317) 682-1872

3229 Broadway
Gary, IN 46409
Phone (219) 326-2324

1992 E Stop 13 Rd
Indianapolis, IN 46227
Phone (317) 808-0230

1505 US Highway 41
Ste A20
Schererville, IN 46375
Phone (219) 322-5560

33900 Harper Ave
Ste 104
Clinton Twp, MI 48035
Phone (586) 416-9100

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523923200000",
    "number": "1083811749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33900 HARPER AVE STE 104",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480354258",
            "telephone_number": "586-350-2644",
            "fax_number": "586-541-3735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12955 OLD MERIDIAN ST STE 101",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460327100",
            "telephone_number": "317-819-6600",
            "fax_number": "317-819-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECARLO",
        "first_name": "MARK",
        "middle_name": "S",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-27",
        "last_updated": "2018-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "050018551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2018; 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.