Individual provider Active NPI

Aivy Marie Mariano

  • Physical Therapist
  • La Mesa, CA
National Provider Identifier
1235941196
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
8380 Center Dr Ste E
La Mesa, CA 91942-2952
Phone
(619) 466-6077
NPI assigned
Jan 27, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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 Primary

Addresses

Primary practice location

8380 Center Dr Ste E
La Mesa, CA 91942-2952

Mailing address

1990 Edison CT
Chula Vista, CA 91915-1459

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250826001109 CA Practitioner - Physical Therapist in Private Practice 5496255283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

600 Mamaroneck Ave
Suite 400
Harrison, NY 10528-1647

8380 Ctr Dr
Suite E
La Mesa, CA 91942

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Therapy Partners Inc Physical Therapist CurrentSince Jul 1, 2025 Accepting new patients
PTP, Inc Physical Therapist CurrentSince Jul 1, 2025 Accepting new patients

Locations

320 W Valley Blvd
Alhambra, CA 91803
Phone (626) 616-8695

8380 Center Dr
Ste E
La Mesa, CA 91942
Phone (619) 466-6077

19115 Colima Rd
Ste 205B
Rowland Heights, CA 91748
Phone 80023438013

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": "1737936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1235941196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 EDISON CT",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919151459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8380 CENTER DR STE E",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919422952",
            "telephone_number": "619-466-6077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIANO",
        "first_name": "AIVY MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-27",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; 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.