Marc Steven Mirisch, P. T., DPT, MBA

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT25666 Issued in CA

Practice address

7469 Las Lunas
San Diego, CA 92127-3851

Phone

(858) 215-2063

NPI assigned

Sep 14, 2008

Last updated

Jul 24, 2020By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Business Administration

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ashcarevirtualservices.marcmirisch@155535.advancedmd-direct.com

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.

• Ashcare Virtual Physical Therapy Associates, PC

  • Physical Therapist
  • San Diego, CA
  • NPI 1437969896
  NPD Authorized official
• Digital Physical Therapy Network P.C.

  • Physical Therapy Clinic/Center
  • San Diego, CA
  • NPI 1558982165
  NPD Authorized official

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

{
    "created_epoch": "1221350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595548800000",
    "number": "1316196470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16091 SAN DIEGUITO RD UNIT 8412",
            "city": "RANCHO SANTA FE",
            "state": "CA",
            "postal_code": "920676773",
            "telephone_number": "858-215-2063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7469 LAS LUNAS",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921273851",
            "telephone_number": "858-215-2063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRISCH",
        "first_name": "MARC",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "P. T., DPT, MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-14",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT25666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carina Mireles-Romo
• Daniela Mireles
• Jessie Miriello, PT
• Seyed Reza Mirin Babazadegan, M.D.
• Azita Mirin, PSY.D.
• Kamron Mirkarimi, M.D.
• Morteza Mirkarimi, MD
• Masha Mirkin, DMD
• Mojdeh Seyedeh Mirmomen
• Crystal Mae Miron

• Physical Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; 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.