Jose Mari Blas Mentzer, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501012518 Issued in MI

Practice address

43217 Cambridge Dr
Sterling Heights, MI 48313-1812

Phone

(586) 838-9256

Fax

(586) 601-2787

NPI assigned

Jul 15, 2010

Last updated

Jul 15, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1279152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279152000000",
    "number": "1710290069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43217 CAMBRIDGE DR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483131812",
            "telephone_number": "586-838-9256",
            "fax_number": "586-601-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43217 CAMBRIDGE DR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483131812",
            "telephone_number": "586-838-9256",
            "fax_number": "586-601-2787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENTZER",
        "first_name": "JOSE MARI",
        "middle_name": "BLAS",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-15",
        "last_updated": "2010-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501012518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Sterling Heights, MI
• Providers in Sterling Heights, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2010; 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.