Individual provider Active NPI

Miranda Mussack, PT, DPT

  • Physical Therapist
  • Laveen, AZ
National Provider Identifier
1578411575
Registry record updated Mar 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
034596 Issued in AZ
Practice address
5215 W Baseline Rd Ste 101
Laveen, AZ 85339-2943
Phone
(623) 219-4600
Fax
(623) 219-4601
NPI assigned
Mar 17, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2026

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 034596 AZ Primary

Addresses

Primary practice location

5215 W Baseline Rd Ste 101
Laveen, AZ 85339-2943

Mailing address

5215 W Baseline Rd Ste 101
Laveen, AZ 85339-2943
Phone (623) 219-4600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260401000196 AZ Practitioner - Physical Therapist in Private Practice 6204311871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spooner Physical Therapy and Hand Rehab, PCGroup PAC ID 3476440447, 202 clinicians

Practice addresses (Care Compare)

5215 W Baseline Rd
Suite 101
Laveen, AZ 85339-2943
Phone (623) 219-4600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
034596AZMDPhysical Therapist

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1773705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1578411575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5215 W BASELINE RD STE 101",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853392943",
            "telephone_number": "623-219-4600",
            "fax_number": "623-219-4601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5215 W BASELINE RD STE 101",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853392943",
            "telephone_number": "623-219-4600",
            "fax_number": "623-219-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSSACK",
        "first_name": "MIRANDA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-17",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "034596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laveen, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2026; 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.