Mark Luis Miclat, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

048774 Issued in NY

Practice address

143 E 34TH St
New York, NY 10016-4713

Phone

(646) 841-1400

NPI assigned

Mar 16, 2023

Last updated

Aug 6, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Spear Physical and Occupational Therapy, LLCGroup PAC ID 6901832112, 582 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Spear Physical and Occupational Therapy, LLC

  • Physical Therapy Clinic/Center
  • New York, NY
  • NPI 1063454577

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Reddy Care Physical Therapy PC

  • Specialist
  • Great Neck, NY
  • NPI 1932171097

  Physical Therapist

  Medicare reassignment NPD
• Healing Therapeutics Physical Therapy Part A, PLLC

  • Physical Therapist
  • Port Chester, NY
  • NPI 1396057881
  NPD (past)

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

{
    "created_epoch": "1678924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1205537057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 E 32ND ST FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165595",
            "telephone_number": "212-759-2282",
            "fax_number": "212-379-2123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 E 34TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100164713",
            "telephone_number": "646-841-1400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "475 Northern Blvd Ste 11",
            "address_purpose": "LOCATION",
            "city": "Great Neck",
            "state": "NY",
            "postal_code": "110214802",
            "country_code": "US",
            "telephone_number": "516-829-0030",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "30 N Main St Ste 2",
            "address_purpose": "LOCATION",
            "city": "Port Chester",
            "state": "NY",
            "postal_code": "105734257",
            "country_code": "US",
            "telephone_number": "914-939-3143",
            "fax_number": "914-939-3120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICLAT",
        "first_name": "MARK LUIS",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-16",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "048774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Mickhael, MD
• Nathan Keeler Mickinac, MD
• Molly Ann Mickle, FNP
• Carl Terence Mickman, MD
• Jenika Miclat, RN
• Mid Atlantic Medical P.C.
• Mid City TMS Psychiatric PLLC
• Mid-Atlantic Medical Services,PC
• Mid-Manhattan Medical, P.C. (Park Avenue Trauma Associates)
• Mid-Manhattan Oral Surgery PC

• Physical Therapist in New York, NY
• Providers in New York, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; 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.