Ross Brian McCormack, PT DPT OCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

37530 Issued in CA

Practice address

77622 Country Club Dr Ste G
Palm Desert, CA 92211-0447

Phone

(760) 345-3087

Fax

(760) 345-6852

NPI assigned

Jun 19, 2012

Last updated

Oct 23, 2023By the provider in NPPES

Sex

Male

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 CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• All Star Physical Therapy

  • Physical Therapist
  • Temecula, CA
  • NPI 1750559431
  Medicare reassignment

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1295098861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LYNDON FARM CT STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235005",
            "telephone_number": "951-335-9825",
            "fax_number": "812-590-8333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77622 COUNTRY CLUB DR STE G",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922110447",
            "telephone_number": "760-345-3087",
            "fax_number": "760-345-6852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMACK",
        "first_name": "ROSS",
        "middle_name": "BRIAN",
        "credential": "PT DPT OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-19",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "37530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chimezie Mbanu, PHARMD
• Teresa McCallister, PHARMD
• Martin Sean McCauley, LPN/LVN
• Sasha Brianne Rashein McClain
• Simone Regine McClain
• Betty Lou McDonald
• Chanette Ann McDonald, DDS
• Megan McDonald, CCC-SLP
• Thomas Scott McGalliard, DDS
• Sherilyn Ann McGee, LVN

• Physical Therapist in Palm Desert, CA
• Providers in Palm Desert, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; 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.