Active NPI
Marc-Olivier Roger Foglia, PTA
- Physical Therapy Assistant
- Los Angeles, CA
National Provider Identifier
1164051397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA48690
- Practice address
- 5401 Fountain Ave
Los Angeles, CA 90029-1006 - Phone
- (323) 465-2106
- NPI assigned
- Apr 8, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA48690 | CA | Primary |
Addresses
Primary practice location
5401 Fountain Ave
Los Angeles, CA 90029-1006
Mailing address
3502 Jasmine Ave Apt 204
Los Angeles, CA 90034-4914
Phone (310) 926-6798
Other practice location 1
3533 Motor Ave
Los Angeles, CA 90034-4806
Phone (310) 836-8900
Other practice location 2
5400 Fountain Ave
Los Angeles, CA 90029-1007
Phone (323) 461-4301
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA48690 | CA | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physicali LLC | Current | Accepting new patients |
Organizations & group practices 1
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.
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- Panorama City, CA
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586304000000",
"number": "1164051397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3502 JASMINE AVE APT 204",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900344914",
"telephone_number": "310-926-6798"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5401 FOUNTAIN AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900291006",
"telephone_number": "323-465-2106"
}
],
"practiceLocations": [
{
"address_1": "3533 Motor Ave",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900344806",
"country_code": "US",
"telephone_number": "310-836-8900",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5400 Fountain Ave",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900291007",
"country_code": "US",
"telephone_number": "323-461-4301",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FOGLIA",
"first_name": "MARC-OLIVIER",
"middle_name": "ROGER",
"name_prefix": "Mr.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-08",
"last_updated": "2020-04-08",
"certification_date": "2020-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "PTA48690",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.