Individual provider Active NPI

Mark Allen Neves, OTRL

  • Occupational Therapist
  • Fremont, CA
National Provider Identifier
1295869923
Registry record updated Mar 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT8813 Issued in CA
Practice address
3575 Beacon Ave
Fremont, CA 94538-1407
Phone
(510) 794-9672
Fax
(510) 792-8138
NPI assigned
Mar 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT8813 CA Primary

Addresses

Primary practice location

3575 Beacon Ave
Fremont, CA 94538-1407

Mailing address

39141 Civic Center Dr
Ste 120
Fremont, CA 94538-5831
Phone (510) 794-9672

Other identifiers 2

IdentifierTypeStateIssuer
CT0088130MedicaidCA
OT0088130OtherCABLUE SHIELD OF CALIFORNIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070501000445 CA Practitioner - Occupational Therapist in Private Practice 4284730672 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians
Burger Physical Therapy Services IncGroup PAC ID 8921019746, 37 clinicians

Practice addresses (Care Compare)

250 W Main St
Woodland, CA 95695-3652
Phone (916) 668-6100

7200 S Land Park Dr
Suite 300
Sacramento, CA 95831-3670
Phone (916) 391-5010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT8813CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Burger Physical Therapy Services Inc CurrentSince Jul 1, 2022 Accepting new patients
Burger Physical Therapy and Rehabilitation Agency Inc Past Accepting new patients

Locations

11990 Heritage Oak Pl
Ste 8
Auburn, CA 95603
Phone (530) 823-6835

1301 E Bidwell St
Ste 201
Folsom, CA 95630

7200 S Land Park Dr
Ste 300
Sacramento, CA 95831
Phone (916) 391-5010

Organizations & group practices 3

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": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520380800000",
    "number": "1295869923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39141 CIVIC CENTER DR",
            "address_2": "STE 120",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945385831",
            "telephone_number": "510-794-9672",
            "fax_number": "510-792-8138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3575 BEACON AVE",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381407",
            "telephone_number": "510-794-9672",
            "fax_number": "510-792-8138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEVES",
        "first_name": "MARK",
        "middle_name": "ALLEN",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2018-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT8813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CT0088130",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "OT0088130",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2018; 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.