Makoto Brandon Iwasaki, MPT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

2305204802 Issued in VA

Practice address

6355 Walker LN
Suite 204
Alexandria, VA 22310-3245

Phone

(703) 921-2167

Fax

(703) 921-1789

NPI assigned

Oct 19, 2006

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)

Enrolled

Practice roles

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.

• Fortanasce Physical Therapy, Inc

  • Physical Therapist
  • Arcadia, CA
  • NPI 1013942036
  NPD (past)

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093897167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 E NELSON AVE",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223012035",
            "telephone_number": "951-990-5318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6355 WALKER LN",
            "address_2": "SUITE 204",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223103245",
            "telephone_number": "703-921-2167",
            "fax_number": "703-921-1789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IWASAKI",
        "first_name": "MAKOTO",
        "middle_name": "BRANDON",
        "name_prefix": "Mr.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "VA",
            "license": "2305204802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gloria J. Ivey-Crowe, M.D.
• William Glenn Ivey III, CSA
• Cathy Ann Mateo Ivory, FNP
• Ivys Touch Home Healthcare LLC
• Jesse Iwanski, MD
• Nobuko Iwasaki, AUD
• Iweartec Corporation
• Linda Owusuaa Iyebote, LICSW
• J & C Behavioral Therapy, LLC
• J. Helen Lee, DDS, PC

• Orthopedic Physical Therapist in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Orthopedic Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.