Individual provider Active NPI

Mary Ann B Romero, PHYSICAL THERAPIST

  • Physical Therapist
  • Edgewood, NM
National Provider Identifier
1144808155
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT5869 Issued in NM
Practice address
1 Linnie CT Ste Apt
Edgewood, NM 87015-9125
Phone
(505) 286-7838
Fax
(505) 286-8025
NPI assigned
Mar 31, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT5869 NM Primary

Addresses

Primary practice location

1 Linnie CT Ste Apt
Edgewood, NM 87015-9125

Mailing address

1 Linnie CT Ste Apt
Edgewood, NM 87015-9125
Phone (505) 286-7838

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL info@secure.activesolutionstherapy.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210518003099 NM Practitioner - Physical Therapist in Private Practice 7113326448 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT5869NMMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Active Solutions Therapy Serv Inc Physical Therapist CurrentSince Apr 14, 2021 Accepting new patients
Paradigm Physical Therapy and Wellness Inc Physical Therapist CurrentSince Aug 15, 2022 Accepting new patients
Paradigm Physical Therapy and Wellness Inc Physical Therapist PastSince Aug 15, 2022 Accepting new patients
Active Solutions Therapy Services, Inc Physical Therapist Past Accepting new patients

Locations

3901 Georgia St NE
Bldg F
Albuquerque, NM 87110
Phone (505) 286-7838

1220 Camino del Llano
Belen, NM 87002
Phone (505) 861-1200

1 Linnie Ct
Edgewood, NM 87015
Phone (505) 286-7838

535 Highway 314 SW
Los Lunas, NM 87031
Phone (505) 861-1200

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1144808155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LINNIE CT STE APT",
            "city": "EDGEWOOD",
            "state": "NM",
            "postal_code": "870159125",
            "telephone_number": "505-286-7838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LINNIE CT STE APT",
            "city": "EDGEWOOD",
            "state": "NM",
            "postal_code": "870159125",
            "telephone_number": "505-286-7838",
            "fax_number": "505-286-8025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMERO",
        "first_name": "MARY ANN",
        "middle_name": "B",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-31",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "PT5869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "info@secure.activesolutionstherapy.com",
            "affiliation": "N",
            "address_1": "1 Linnie Ct Ste Apt",
            "city": "Edgewood",
            "state": "NM",
            "country_code": "US",
            "postal_code": "870159125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Edgewood, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; 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.