Individual provider Active NPI

Mark Lester Muyco Delgado, P.T.

  • Physical Therapist
  • Yakima, WA
National Provider Identifier
1689818320
Registry record updated Dec 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00010664 Issued in WA
Practice address
302 S 10TH Ave
Yakima, WA 98902-3521
Phone
(509) 574-3600
NPI assigned
Apr 24, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 25, 2014

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 PT00010664 WA Primary
Physical Therapist 225100000X 5546 OR

Addresses

Primary practice location

302 S 10TH Ave
Yakima, WA 98902-3521

Mailing address

302 S 10TH Ave
Yakima, WA 98902-3521
Phone (509) 574-3600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5546ORMDPhysical Therapist
PT00010664WAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1240531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419465600000",
    "number": "1689818320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 S 10TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023521",
            "telephone_number": "509-574-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 S 10TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023521",
            "telephone_number": "509-574-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELGADO",
        "first_name": "MARK LESTER",
        "middle_name": "MUYCO",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-24",
        "last_updated": "2014-12-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00010664",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "5546",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.