Rise Orthopedic and Sports Physical Therapy LLC

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

5576 Issued in AZ

Legal business name

RISE ORTHOPEDIC AND SPORTS PHYSICAL THERAPY LLC

Practice address

12515 W Bell Rd Suite 103
Surprise, AZ 85378-3801

Phone

(623) 234-4171

Fax

(623) 234-4173

NPI assigned

Oct 16, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Mark Andrew Jagodzinski, PTNPI 1891732467

Title

Owner

Phone

(623) 234-4171

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Andrew Jagodzinski, PT

  • Orthopedic Physical Therapist
  • Surprise, AZ
  • NPI 1891732467
  Medicare reassignment NPD Authorized official
• Shea KL Campbell, PT, DPT

  • Orthopedic Physical Therapist
  • Surprise, AZ
  • NPI 1871979195
  Medicare reassignment NPD
• Natalie Thomas, PTA

  • Physical Therapy Assistant
  • Surprise, AZ
  • NPI 1629859251
  NPD
• Ochuko Ojameruaye, DPT

  • Physical Therapist
  • Saint Louis, MO
  • NPI 1265925267
  NPD (past)

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

{
    "created_epoch": "1508112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687737600000",
    "number": "1366953549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12515 W BELL RD SUITE 103",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853783801",
            "telephone_number": "623-234-4171",
            "fax_number": "623-234-4173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12515 W BELL RD SUITE 103",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853783801",
            "telephone_number": "623-234-4171",
            "fax_number": "623-234-4173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RISE ORTHOPEDIC AND SPORTS PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-16",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A",
        "authorized_official_last_name": "JAGODZINSKI",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-234-4171",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "AZ",
            "license": "5576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "738692",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madison Riddick
• Miesha Ridgeway
• Katherine Riehm
• Phillip Rinaldo, DC
• Brenda G Rincon
• Emma Risk, LAT, ATC
• Paola Marie Rivera Diaz
• Alissa Monique Rivera Olguin, FNP
• Frank Rivera III
• Kimberly Rivera, EDS, NCSP

• Orthopedic Physical Therapist in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Orthopedic Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.