Organization Active NPI

Synergy Plus PT Inc

  • Physical Therapist
  • Corte Madera, CA
National Provider Identifier
1104151745
Registry record updated Mar 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT28427 Issued in CA
Legal business name
SYNERGY PLUS PT INC
Practice address
500 Tamal PLZ
Suite 507
Corte Madera, CA 94925-1151
Phone
(415) 924-2228
NPI assigned
Oct 15, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2015

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

Authorized official

Name
Tiziano Grifoni
Title
Cfo
Phone
(415) 924-2228

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT28427 CA Primary

Addresses

Primary practice location

500 Tamal PLZ
Suite 507
Corte Madera, CA 94925-1151

Mailing address

500 Tamal PLZ
Suite 507
Corte Madera, CA 94925-1151
Phone (415) 924-2228

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151030001048 CA Part B Supplier - Clinic/Group Practice 9638489875 Receives reassigned benefits from 3 practitioners
Practice locations: San Rafael, CA

National Provider Directory

National Provider Directory

Locations

25 Tamalpais Ave
Ste A
San Anselmo, CA 94960
Phone (415) 258-8228

834 5th Ave
San Rafael, CA 94901
Phone (415) 924-2228

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1255564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427760000000",
    "number": "1104151745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 TAMAL PLZ",
            "address_2": "SUITE 507",
            "city": "CORTE MADERA",
            "state": "CA",
            "postal_code": "949251151",
            "telephone_number": "415-924-2228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 TAMAL PLZ",
            "address_2": "SUITE 507",
            "city": "CORTE MADERA",
            "state": "CA",
            "postal_code": "949251151",
            "telephone_number": "415-924-2228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY PLUS PT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-15",
        "last_updated": "2015-03-31",
        "status": "A",
        "authorized_official_last_name": "GRIFONI",
        "authorized_official_first_name": "TIZIANO",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "415-924-2228"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT28427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corte Madera, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.