Individual provider Active NPI

Mario Teering, P.T.

  • Physical Therapist
  • Salinas, CA
National Provider Identifier
1174698013
Registry record updated Jan 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT16753 Issued in CA
Practice address
505 E Romie LN Ste I
Salinas, CA 93901-4031
Phone
(831) 757-3055
Fax
(831) 757-5622
NPI assigned
Nov 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2012

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 PT16753 CA Primary

Addresses

Primary practice location

505 E Romie LN Ste I
Salinas, CA 93901-4031

Mailing address

1303 David Ave
Pacific Grove, CA 93950-5508
Phone (831) 333-1187

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120126000491 CA Practitioner - Physical Therapist in Private Practice 0648216309 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16753CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Axis Physical Therapy Physical Therapist CurrentSince Jan 1, 1999 Accepting new patients
Leo L Fong Corporation PastSince Jan 1, 1999 Accepting new patients

Locations

610 Forest Ave
Pacific Grove, CA 93950
Phone (831) 655-9881

505 E Romie Ln
Ste 1
Salinas, CA 93901

505 E Romie Ln
Ste I
Salinas, CA 93901
Phone (559) 721-4910

Organizations & group practices 2

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": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326931200000",
    "number": "1174698013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 DAVID AVE",
            "city": "PACIFIC GROVE",
            "state": "CA",
            "postal_code": "939505508",
            "telephone_number": "831-333-1187",
            "fax_number": "831-333-1187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 E ROMIE LN STE I",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939014031",
            "telephone_number": "831-757-3055",
            "fax_number": "831-757-5622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEERING",
        "first_name": "MARIO",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2012-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT16753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salinas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2012; 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.