Mark Anthony Pacchiano, MSPT, MTC, CSCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

021520-1 Issued in NY

Practice address

259 Jefferson Blvd
Staten Island, NY 10312-3001

Phone

(718) 356-2919

Fax

(718) 356-6015

NPI assigned

Dec 11, 2006

Sex

Male

Sole proprietor

Yes

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 NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Core Physical Therapy and Sport Rehabilitation PCGroup PAC ID 3274624465, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Core Physical Therapy & Sport Rehabilitation PC

  • Physical Therapist
  • Staten Island, NY
  • NPI 1306979075
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1104986223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 JEFFERSON BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103123001",
            "telephone_number": "718-356-2919",
            "fax_number": "718-356-6015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 JEFFERSON BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103123001",
            "telephone_number": "718-356-2919",
            "fax_number": "718-356-6015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACCHIANO",
        "first_name": "MARK",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "MSPT, MTC, CSCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "021520-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Visitacion Pabicon, MD
• Joseph Paulino Pablo, OTR/L
• Maria Pablo, M.D.
• Priscilla Claudia Albano Pablo
• Jennifer Rachel Pacchiano, MS OTR/L
• Pace Set Medics LLC
• Mark Orson Pachas, LMSW
• Ursula Pachas, RN
• Ruth Pacheco
• Tiffany Pacheco, PMHNP-BC

• Physical Therapist in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; 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.