Carl Malmquist IV

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305216263 Issued in VA

Practice address

392 Garrisonville Rd Ste 211
Stafford, VA 22554-1500

Phone

(540) 602-4277

NPI assigned

Dec 5, 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

Enrolled in VA, NC2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Creighton University School of Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Synergy Physical Therapy and Sports Medicine LLCGroup PAC ID 7911156559, 4 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.

• Synergy Physical Therapy & Sports Medicine LLC

  • Physical Therapy Clinic/Center
  • Jacksonville, NC
  • NPI 1326300013

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Tidewater Physical Therapy, LLC

  • Physical Therapist
  • Glen Allen, VA
  • NPI 1457389595
  Medicare reassignment NPD
• Tidewater Physical Therapy, LLC

  • Physical Therapist
  • Roanoke, VA
  • NPI 1437664356
  NPD

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

{
    "created_epoch": "1701734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1093582645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "991 FORSYTHIA LN",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225547360",
            "telephone_number": "928-581-9810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "392 GARRISONVILLE RD STE 211",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225541500",
            "telephone_number": "540-602-4277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALMQUIST",
        "first_name": "CARL",
        "name_suffix": "IV",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-05",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305216263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tatyana Maizel, M.A.,LPC, NCC, CCTP
• Brianna Major
• Paul James Makin
• Tasha Yi Malachi
• Matthew Thomas Malanga
• Elizabeth Ann Malsam, R.PH.
• Jenise Mancini, O.D.
• Diana Mandujano Mendez
• Rebecca M Mani, LCSW
• Tammy Maniscalco, FNP

• Physical Therapist in Stafford, VA
• Providers in Stafford, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; 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.