Mira H Mariano, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305005017 Issued in VA

Practice address

7419 Granby Street
North Shore Sports & Physical Therapy
Norfolk, VA 23505

Phone

(757) 489-5820

Fax

(757) 489-5822

NPI assigned

Feb 14, 2008

Last updated

Feb 14, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Old Dominion UniversityGroup PAC ID 3476770520, 13 clinicians

Pt2Go LLCGroup PAC ID 8921335316, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Old Dominion University

  dba ODU Monarch Physical Therapy

  • Physical Therapist
  • Norfolk, VA
  • NPI 1871929729
  Medicare reassignment Care Compare group NPD
• Pt2Go, LLC

  dba Pt2go

  • Physical Therapist
  • VA BCH, VA
  • NPI 1639636517
  Medicare reassignment Care Compare group NPD
• Vim LLC

  • Physical Therapist
  • Virginia Beach, VA
  • NPI 1083480651
  NPD

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

{
    "created_epoch": "1202947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202947200000",
    "number": "1205004041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7419 GRANBY STREET",
            "address_2": "NORTH SHORE SPORTS & PHYSICAL THERAPY",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "23505",
            "telephone_number": "757-489-5820",
            "fax_number": "757-489-5822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7419 GRANBY STREET",
            "address_2": "NORTH SHORE SPORTS & PHYSICAL THERAPY",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "23505",
            "telephone_number": "757-489-5820",
            "fax_number": "757-489-5822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIANO",
        "first_name": "MIRA",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-14",
        "last_updated": "2008-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305005017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katrina Anne Marcinkowski, MD
• Marian Marconyak, PHD, PT
• Michael A Marcou, D.D.S
• Christine Jane Marczak, RDH
• Marechal-Neil Brooks,M.D.,P.C.
• Robert T Mariano, MD
• Marieta a Bajit MD
• Paul E. Marik, M.D.
• Jennifer L Maritz, LCSW
• Jonathan Russell Mark, M.D.

• Physical Therapist in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2008; 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.