Individual provider Active NPI

Ezequiel Alfredo Marzocchetti, PT

  • Physical Therapist
  • Palmdale, CA
National Provider Identifier
1477638229
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT26241 Issued in CA
Practice address
1115 W Ave M-14
Palmdale, CA 93551
Phone
(661) 265-0060
Fax
(661) 265-0199
NPI assigned
Oct 26, 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 PT26241 CA Primary

Addresses

Primary practice location

1115 W Ave M-14
Palmdale, CA 93551

Mailing address

1115 W Ave M-14
Palmdale, CA 93551
Phone (661) 265-0060

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040308001442 CA Practitioner - Physical Therapist in Private Practice 6305734682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Point Physical Therapy Center, IncGroup PAC ID 2163310426, 5 clinicians

Practice addresses (Care Compare)

1115 W Ave
M14
Palmdale, CA 93551-1407
Phone (661) 265-0060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT26241CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
West Point Physical Therapy Center, Inc Physical Therapist CurrentSince Jan 15, 2020 Accepting new patients

Locations

9300 N Loop Blvd
California City, CA 93505
Phone (619) 373-4809

68845 Perez Rd
#H6
Cathedral Cty, CA 92234
Phone (760) 328-0292

1115 W Avenue M14
Palmdale, CA 93551
Phone (661) 265-0060

1431 W Rosamond Blvd
Ste 11
Rosamond, CA 93560

Organizations & group practices 1

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477638229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 W AVE M-14",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "93551",
            "telephone_number": "661-265-0060",
            "fax_number": "661-265-0199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 W AVE M-14",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "93551",
            "telephone_number": "661-265-0060",
            "fax_number": "661-265-0199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARZOCCHETTI",
        "first_name": "EZEQUIEL",
        "middle_name": "ALFREDO",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT26241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, 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.
  • 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.