Individual provider Active NPI

Anna Cardosa Gray, PT

  • Physical Therapist
  • Phoenix, AZ
National Provider Identifier
1376536250
Registry record updated Mar 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
LPT6191 Issued in AZ
Practice address
2302 N 15TH Ave
Phoenix, AZ 85007-1201
Phone
(623) 242-6908
Fax
(623) 242-6909
NPI assigned
Aug 25, 2005
Last updated
Mar 27, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X LPT6191 AZ
Physical Therapist 225100000X LPT6191 AZ Primary

Addresses

Primary practice location

2302 N 15TH Ave
Phoenix, AZ 85007-1201

Mailing address

4948 W Purdue Ave
Glendale, AZ 85302-3530
Phone (623) 512-6156

Other practice location 1

14557 W Indian School Rd
Goodyear, AZ 85395-9218
Phone (623) 242-6908

Other identifiers 1

IdentifierTypeStateIssuer
811415OtherAZARIZONA HEATHCARE COST CONTAINMENT SYSTEM (AHCCCS)

Other names 1

  • Anna L Cardosa Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPT6191AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Above & Beyond Therapy Services LLC Physical Therapist PastSince Jun 7, 2018 Accepting new patients
Above & Beyond Therapy Services Specialist Past Accepting new patients
Arizona Orthopedic Physical Therapy, PLLC PastSince Jan 1, 2007 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585267200000",
    "number": "1376536250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4948 W PURDUE AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853023530",
            "telephone_number": "623-512-6156",
            "fax_number": "800-915-4197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2302 N 15TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850071201",
            "telephone_number": "623-242-6908",
            "fax_number": "623-242-6909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14557 W Indian School Rd",
            "address_purpose": "LOCATION",
            "city": "Goodyear",
            "state": "AZ",
            "postal_code": "853959218",
            "country_code": "US",
            "telephone_number": "623-242-6908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARDOSA GRAY",
        "first_name": "ANNA",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-25",
        "last_updated": "2020-03-27",
        "certification_date": "2020-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "AZ",
            "license": "LPT6191",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT6191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA HEATHCARE COST CONTAINMENT SYSTEM (AHCCCS)",
            "identifier": "811415",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "CARDOSA",
            "middle_name": "L",
            "credential": "M.P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.