Individual provider Active NPI

Mark Sansone, RPT

  • Physical Therapist
  • Placerville, CA
National Provider Identifier
1225008386
Registry record updated Mar 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 13745 Issued in CA
Practice address
3084 Cedar Ravine Rd
Placerville, CA 95667-5617
Phone
(530) 621-2773
Fax
(530) 621-3202
NPI assigned
Jan 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 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 PT 13745 CA Primary

Addresses

Primary practice location

3084 Cedar Ravine Rd
Placerville, CA 95667-5617

Mailing address

104 Clemsford SQ
Folsom, CA 95630-6787
Phone (916) 983-4713

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 13745CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Physical Therapy Clinics, Inc. Physical Therapist PastSince Aug 9, 2013 Accepting new patients
Sacramento Spine & Physical Therapy Inc. Physical Therapist Past Accepting new patients
The Physical Therapy Clinics, Inc. Physical Therapist Past Accepting new patients
East Sacramento Physical Therapy, Inc Physical Therapist Past Accepting new patients
Advanced Physical Therapy Past Accepting new patients

Organizations & group practices 5

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": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331596800000",
    "number": "1225008386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 CLEMSFORD SQ",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956306787",
            "telephone_number": "916-983-4713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3084 CEDAR RAVINE RD",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956675617",
            "telephone_number": "530-621-2773",
            "fax_number": "530-621-3202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANSONE",
        "first_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2012-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 13745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Placerville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.