Marc Andrew Moreno

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

304495 Issued in CA

Practice address

16300 Roscoe Blvd Ste A1
Van Nuys, CA 91406-1246

Phone

(818) 893-4426

NPI assigned

Aug 7, 2023

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 CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

All Star Physical TherapyGroup PAC ID 7719030949, 149 clinicians

Michael Martines Physical TherapistGroup PAC ID 0244402857, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• All Star Physical Therapy

  • Physical Therapist
  • Murrieta, CA
  • NPI 1750559431
  Medicare reassignment Care Compare group NPD
• Michael Martines Physical Therapist,

  dba Advanced Physical Therapy

  • Physical Therapy Clinic/Center
  • Fresno, CA
  • NPI 1841517026

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Advanced Physical and Occupational Therapy

  • Physical Therapy Clinic/Center
  • Fresno, CA
  • NPI 1518159607

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1691366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1629750815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20323 GRESHAM ST",
            "city": "WINNETKA",
            "state": "CA",
            "postal_code": "913061122",
            "telephone_number": "818-439-0182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16300 ROSCOE BLVD STE A1",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914061246",
            "telephone_number": "818-893-4426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "MARC",
        "middle_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-07",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "304495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Giovanna Morelos
• Madison Taylor Moreno Najera
• Noel Moreno-Salazar
• Carlos Moreno Jr.
• Gabriela Moreno
• Mariana Moreno
• Michelle Moreno
• Deshaun Morgan
• Dominique Morgan
• Lisa Marie Morin

• Physical Therapist in Van Nuys, CA
• Providers in Van Nuys, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; 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.