Randie Mendoza Ocomen, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501005670 Issued in MI

Practice address

110 E Huron Ave Ste B
Bad Axe, MI 48413-1313

Phone

(989) 553-5348

NPI assigned

Apr 15, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Active Rehab Group LLCGroup PAC ID 2163571670, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Active Rehab Group LLC

  • Rehabilitation Hospital Unit
  • Bad Axe, MI
  • NPI 1669615993

  MI, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Active Rehab of Michigan

  • Physical Therapist
  • Bad Axe, MI
  • NPI 1235488230
  NPD (past)

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

{
    "created_epoch": "1239753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239753600000",
    "number": "1508009895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E HURON AVE STE B",
            "city": "BAD AXE",
            "state": "MI",
            "postal_code": "484131313",
            "telephone_number": "989-553-5348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E HURON AVE STE B",
            "city": "BAD AXE",
            "state": "MI",
            "postal_code": "484131313",
            "telephone_number": "989-553-5348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OCOMEN",
        "first_name": "RANDIE",
        "middle_name": "MENDOZA",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-15",
        "last_updated": "2009-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501005670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Craig Osentoski, R.PH.

• All providers in Bad Axe, MI
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2009; 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.