Individual provider Active NPI

Mark Anthony Palacios, P.T.

  • Physical Therapist
  • West Covina, CA
National Provider Identifier
1336473388
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT29218 Issued in CA
Practice address
2934 E Garvey Ave S Ste 250
West Covina, CA 91791-2186
Phone
(909) 802-5824
NPI assigned
Sep 23, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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 PT29218 CA Primary

Addresses

Primary practice location

2934 E Garvey Ave S Ste 250
West Covina, CA 91791-2186

Mailing address

2934 E Garvey Ave S Ste 250
West Covina, CA 91791-2186
Phone (909) 802-5824

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100203000170 CA Practitioner - Physical Therapist in Private Practice 3577606300 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9631 Monte Vista Ave
Montclair, CA 91763-2233
Phone (909) 802-5824

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT29218CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic and Neurological Rehab Inc Physical Therapist CurrentSince Oct 28, 2021 Accepting new patients
Rehabmark Therapy and Wellness, a Physical Therapy, Inc. Physical Therapist CurrentSince Mar 17, 2025 Accepting new patients
Orthopaedic and Neurological Rehabilitation, Speech Pathology, Inc CurrentSince Oct 28, 2021 Accepting new patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince May 2, 2022 Accepting new patients
Rehabmark Therapy and Wellness,LLC Physical Therapist CurrentSince Sep 4, 2022 Accepting new patients

Locations

2950 Sierra Sunrise Ter
Chico, CA 95928
Phone (530) 941-1017

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108

3900 Dale Rd
Modesto, CA 95356
Phone (209) 492-0128

9631 Monte Vista Ave
Montclair, CA 91763
Phone (626) 272-2937

2934 E Garvey Ave S
Ste 250
West Covina, CA 91791
Phone (657) 387-2015

8500 Bluffstone Cv
Ste A201
Austin, TX 78759
Phone (512) 220-5252

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": "1253664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1336473388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2934 E GARVEY AVE S STE 250",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917912186",
            "telephone_number": "909-802-5824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2934 E GARVEY AVE S STE 250",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917912186",
            "telephone_number": "909-802-5824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALACIOS",
        "first_name": "MARK ANTHONY",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-23",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT29218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; 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.