Individual provider Active NPI

Mary L. Romero, MPT

  • Physical Therapist
  • Tolleson, AZ
National Provider Identifier
1164552634
Registry record updated Apr 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5948 Issued in AZ
Practice address
9550 W Van Buren St
Suite 14 a
Tolleson, AZ 85353-2826
Phone
(623) 322-4917
Fax
(623) 322-8625
NPI assigned
Mar 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2017

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 5948 AZ Primary

Addresses

Primary practice location

9550 W Van Buren St
Suite 14 a
Tolleson, AZ 85353-2826

Mailing address

9550 W Van Buren St
Suite 14 a
Tolleson, AZ 85353-2826
Phone (623) 322-4917

Other identifiers 1

IdentifierTypeStateIssuer
094354MedicaidAZ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151230000626 AZ Practitioner - Physical Therapist in Private Practice 4385860212 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

9550 W Van Buren St
Suite 14
Tolleson, AZ 85353-2826
Phone (623) 322-4917

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5948AZMDPhysical Therapist

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.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492041600000",
    "number": "1164552634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9550 W VAN BUREN ST",
            "address_2": "SUITE 14 A",
            "city": "TOLLESON",
            "state": "AZ",
            "postal_code": "853532826",
            "telephone_number": "623-322-4917",
            "fax_number": "623-322-8625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9550 W VAN BUREN ST",
            "address_2": "SUITE 14 A",
            "city": "TOLLESON",
            "state": "AZ",
            "postal_code": "853532826",
            "telephone_number": "623-322-4917",
            "fax_number": "623-322-8625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMERO",
        "first_name": "MARY",
        "middle_name": "L.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2017-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "5948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "094354",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tolleson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2017; 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.