Mary Rachel Portillo Lozada, PT

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

40QA01671600 Issued in NJ

Practice address

108 S Washington Ave Ste B
Bergenfield, NJ 07621-2341

Phone

(315) 591-5630

NPI assigned

Sep 13, 2016

Sex

Female

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 NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sportsmed PT LLCGroup PAC ID 0749535805, 183 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Sportsmed PT LLC

  • Physical Therapist
  • Glen Rock, NJ
  • NPI 1841787645

  Physical Therapy

  Medicare reassignment Care Compare group NPD
• Advanced Acupuncture Center LLC

  • Acupuncturist
  • Fair Lawn, NJ
  • NPI 1568735728
  NPD (past)

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

{
    "created_epoch": "1473724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473724800000",
    "number": "1144778606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 S WASHINGTON AVE STE B",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076212341",
            "telephone_number": "315-591-5630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 S WASHINGTON AVE STE B",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076212341",
            "telephone_number": "315-591-5630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOZADA",
        "first_name": "MARY RACHEL",
        "middle_name": "PORTILLO",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-13",
        "last_updated": "2016-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NJ",
            "license": "40QA01671600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ming-Kong Liu, M.D.
• LMG Medical Group, LLC
• Marisa Giovanna Lonardo-Xu, MS, SLP-CCC
• Maria Ana Lopez, DNP, APN
• Zsamae C Lopez, FNP-BC
• Rommell Lozada
• Maxine Luciano
• Denniss Adajar Magpantay, P.T.
• Cristal Mahadeo
• Maryellen Maher

• Physical Therapy Clinic/Center in Bergenfield, NJ
• Providers in Bergenfield, NJ by specialty
• Physical Therapy Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2016; 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.