Mark Brostman, PT, DPT
Individual provider Active NPI Physical Therapist · Arroyo Grande, CA
NPI 1104295872 · NPPES record last updated Sep 2, 2023
Key facts
- NPI
- 1104295872
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 293208 (CA)
- Practice address
- 1055 Rogers CT
Arroyo Grande, CA 93420-4123 - Phone
- (248) 891-0301
- NPI assigned
- Sep 23, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Movebetter Physical Therapy PC
Practice addresses (Care Compare)
1055 Rogers CT
Arroyo Grande, CA 93420-4123
Phone (248) 891-0301
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231018003554 | CA | Practitioner - Physical Therapist in Private Practice | 3779891056 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Movebetter Physical Therapy PC | Physical Therapist | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 293208 | CA | Yes |
| Physical Therapist | 225100000X | 5501017360 | MI | |
| Physical Therapist | 225100000X | 05012399A | IN |
Addresses
Primary practice location
1055 Rogers CT
Arroyo Grande, CA 93420-4123
Mailing address
1055 Rogers CT
Arroyo Grande, CA 93420-4123
Phone (248) 891-0301
Other practice location 1
3145 W Clark Rd
Ste 106
Ypsilanti, MI 48197-1120
Phone (734) 528-9760
Other providers in Arroyo Grande, CA
- Elaine Brielle
- Elizabeth Ann McCain Briggs
- Ernest Stewart Brigham
- Katherine Ann Bringle
- Brittany Bovee, Licensed Clinical Social Worker, Inc., Branching Roots Counseling
- Deanna Marie Brown
- Browne Psychological Services, LLC
- Shelly A. Browne
- Mary Anne Bruggeman
- Jason Aquino Buranday
All providers in Arroyo Grande, CA · Physical Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 2, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.