Individual provider Active NPI

Sandra Marquez

  • Physical Therapist
  • Las Vegas, NV
National Provider Identifier
1629427745
Registry record updated Feb 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4103 Issued in NV
Practice address
4510 S Eastern Ave Ste 9
Las Vegas, NV 89119-6118
Phone
(847) 471-2436
NPI assigned
Jun 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070017100 IL
Physical Therapist 225100000X 4103 NV Primary

Addresses

Primary practice location

4510 S Eastern Ave Ste 9
Las Vegas, NV 89119-6118

Mailing address

4510 S Eastern Ave Ste 9
Las Vegas, NV 89119-6118
Phone (847) 471-2436

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210506002988 NV Practitioner - Physical Therapist in Private Practice 1355750126 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maxicare Therapy and Wellness of NevadaGroup PAC ID 4183033954, 8 clinicians

Practice addresses (Care Compare)

4510 S Eastern Ave
Suite 5
Las Vegas, NV 89119-6118
Phone 702381605363

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070017100ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nevada Luna Care Physical Therapy LLC Physical Therapist CurrentSince Oct 13, 2023 Accepting new patients
Maxicare Therapy and Wellness of Nevada Physical Therapist CurrentSince Feb 1, 2021 Accepting new patients

Locations

4510 S Eastern Ave
Ste 9
Las Vegas, NV 89119
Phone (702) 732-3800

4510 S Eastern Ave
Ste 5
Las Vegas, NV 89119
Phone (702) 381-6053

5940 S Rainbow Blvd
Las Vegas, NV 89118
Phone (702) 203-1964

Organizations & group practices 2

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": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582243200000",
    "number": "1629427745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4510 S EASTERN AVE STE 9",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891196118",
            "telephone_number": "847-471-2436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 S EASTERN AVE STE 9",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891196118",
            "telephone_number": "847-471-2436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARQUEZ",
        "first_name": "SANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-09",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070017100",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "4103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; 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.