Individual provider Active NPI

Marcus Genevro, DPT

  • Physical Therapist
  • Tempe, AZ
National Provider Identifier
1639625320
Registry record updated Feb 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12421 Issued in AZ
Practice address
5110 S Rural Rd
Ste 104
Tempe, AZ 85282-7289
Phone
(480) 629-5549
Fax
(480) 629-5493
NPI assigned
Sep 1, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2017

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 12421 AZ Primary

Addresses

Primary practice location

5110 S Rural Rd
Ste 104
Tempe, AZ 85282-7289

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170309000558 AZ Practitioner - Physical Therapist in Private Practice 8123302288 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Therapy LLCGroup PAC ID 9436288636, 13 clinicians

Practice addresses (Care Compare)

7310 N 16TH St
Phoenix, AZ 85020-5258

Merit-based Incentive Payment System (MIPS)

Final score
17.59 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
58.64

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Therapy LLC CurrentSince Aug 1, 2020 Accepting new patients
Ati Holdings of Arizona, LLC Physical Therapist CurrentSince Aug 1, 2016 Accepting new patients
Ideal Rehabilitation LLC Past Accepting new patients

Locations (25 of 46)

11335 W Buckeye Rd
Ste C105
Avondale, AZ 85323

235 S Dobson Rd
Ste 3
Chandler, AZ 85224
Phone (480) 306-5832

960 E Warner Rd
Ste 7
Chandler, AZ 85225
Phone (480) 417-4930

3131 S Market St
Ste 109
Gilbert, AZ 85295

9494 W Northern Ave
Ste 114
Glendale, AZ 85305
Phone (623) 745-3112

18561 N 59th Ave
Ste 117
Glendale, AZ 85308
Phone (602) 313-4089

380 N Estrella Pkwy
Ste A1
Goodyear, AZ 85338
Phone (480) 455-6266

1752 S Signal Butte Rd
Ste D108
Mesa, AZ 85209
Phone (480) 417-5281

1712 S Country Club Dr
Ste 101
Mesa, AZ 85210
Phone (602) 313-4337

6632 E Baseline Rd
Ste 102
Mesa, AZ 85206
Phone (480) 219-7519

805 N Dobson Rd
Ste 105
Mesa, AZ 85201
Phone (480) 844-3609

3048 E Baseline Rd
Ste 125
Mesa, AZ 85204
Phone (480) 306-8512

4360 E Brown Rd
Ste 111
Mesa, AZ 85205
Phone (480) 248-7132

10355 N La Canada Dr
Ste 125
Oro Valley, AZ 85737
Phone (520) 407-5966

12162 N Rancho Vistoso Blvd
Ste 120
Oro Valley, AZ 85755
Phone (520) 229-0009

9127 W Thunderbird Rd
Ste 101
Peoria, AZ 85381
Phone (623) 322-0654

706 E Bell Rd
Ste 121
Phoenix, AZ 85022
Phone (602) 313-4022

333 E Osborn Rd
Ste 101
Phoenix, AZ 85012
Phone (602) 388-4026

11209 N Tatum Blvd
Ste B120
Phoenix, AZ 85028
Phone (602) 595-0204

6036 N 19th Ave
Ste 303
Phoenix, AZ 85015
Phone (602) 313-4155

3900 E Camelback Rd
Ste 185
Phoenix, AZ 85018
Phone (623) 233-8098

7310 N 16th St
Ste 100
Phoenix, AZ 85020

2005 W Happy Valley Rd
Ste 170
Phoenix, AZ 85085
Phone (623) 322-0654

9250 W Thomas Rd
Ste 280
Phoenix, AZ 85037
Phone (602) 313-4227

3201 W Peoria Ave
Ste B408
Phoenix, AZ 85029
Phone (602) 296-7018

Organizations & group practices 3

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": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487808000000",
    "number": "1639625320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223",
            "fax_number": "630-759-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5110 S RURAL RD",
            "address_2": "STE 104",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827289",
            "telephone_number": "480-629-5549",
            "fax_number": "480-629-5493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENEVRO",
        "first_name": "MARCUS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-01",
        "last_updated": "2017-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "12421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2017; 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.