Individual provider Active NPI

Mark Calderbank, P.T.

  • Physical Therapist
  • Burlingame, CA
National Provider Identifier
1407806813
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 27360 Issued in CA
Practice address
1828 El Camino Real
#702
Burlingame, CA 94010-3103
Phone
(650) 692-4811
Fax
(650) 692-4817
NPI assigned
May 10, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT 27360 CA Primary

Addresses

Primary practice location

1828 El Camino Real
#702
Burlingame, CA 94010-3103

Mailing address

1170 Foster City Blvd
315
Foster City, CA 94404-3374
Phone (650) 619-5845

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
27360CAMDMarriage & Family Therapist
PT 27360CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Restor Physical Therapy Physical Therapist Past Accepting new patients
Burlingame Therapeutic Associatesii Physical Therapist PastSince Feb 13, 2013 Accepting new patients
Richard P Carr Physical Therapy Inc Physical Therapist Past 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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407806813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170 FOSTER CITY BLVD",
            "address_2": "315",
            "city": "FOSTER CITY",
            "state": "CA",
            "postal_code": "944043374",
            "telephone_number": "650-619-5845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1828 EL CAMINO REAL",
            "address_2": "#702",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103103",
            "telephone_number": "650-692-4811",
            "fax_number": "650-692-4817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDERBANK",
        "first_name": "MARK",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 27360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlingame, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.