Mark Frasco

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11405580-2401 Issued in UT

Practice address

4785 W 4100 S
West Valley City, UT 84120-4959

Phone

(801) 955-0500

NPI assigned

Nov 11, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ipta Clinical, LLCGroup PAC ID 0749456119, 126 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.

• Ipta Clinical, LLC

  • Physical Therapy Clinic/Center
  • Medford, NJ
  • NPI 1760764484

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• 3 Dimensional Physical Therapy - Pelvic Health LLC

  • Physical Therapist
  • Medford, NJ
  • NPI 1275348500
  NPD (past)

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

{
    "created_epoch": "1605052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1154923464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4785 W 4100 S",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841204959",
            "telephone_number": "801-955-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4785 W 4100 S",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841204959",
            "telephone_number": "801-955-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRASCO",
        "first_name": "MARK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-11",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "11405580-2401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "11405580-2401",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles Foster
• Alexander Gary Fowler, MS (CLINICAL PSYCH)
• Roman Fox-Nikolaev
• Heidi Dawn Frandsen
• Hope Franks
• Amy Julianna Frascone
• Fresenius Medical Care Utah, LLC
• Andrea Frodsham, FNP-C
• Michael Ron Frogley, D.C.
• Ryan K Frome, D.O.

• Physical Therapist in West Valley City, UT
• Providers in West Valley City, UT by specialty
• Physical Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2020; 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.