Individual provider Active NPI

Jordan Morino, PT

  • Physical Medicine & Rehabilitation Physician
  • Glendale, AZ
National Provider Identifier
1740866623
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
LPT-31675 Issued in AZ
Practice address
17100 N 67TH Ave BLDG 100
Glendale, AZ 85308-3612
Phone
(623) 979-2747
Fax
(623) 979-3122
NPI assigned
Mar 22, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X LPT-31675 AZ Primary

Addresses

Primary practice location

17100 N 67TH Ave BLDG 100
Glendale, AZ 85308-3612

Mailing address

17100 N 67TH Ave BLDG 100
Glendale, AZ 85308-3612
Phone (623) 979-2747

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL GLENDALE Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230622000420 NV Practitioner - Physical Therapist in Private Practice 2860850955 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nevada Physical Therapy IncGroup PAC ID 2668476987, 9 clinicians

Practice addresses (Care Compare)

1413 S Virginia St
Reno, NV 89502-2805
Phone (775) 507-4210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPT-31675AZMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nevada Physical Therapy Inc Physical Therapist CurrentSince Jun 1, 2023 Accepting new patients
Aris Health Corportation Physical Therapist CurrentSince Mar 28, 2021 Accepting new patients

Locations

17100 N 67th Ave
Ste 100
Glendale, AZ 85308
Phone (623) 979-2747

1413 S Virginia St
Reno, NV 89502
Phone (775) 507-4210

5255 Longley Ln
Ste 140
Reno, NV 89511
Phone (775) 507-7024

2484 Wingfield Hills Rd
Ste C120
Sparks, NV 89436
Phone (775) 993-3640

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": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1740866623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17100 N 67TH AVE BLDG 100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853083612",
            "telephone_number": "623-979-2747",
            "fax_number": "623-979-3122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17100 N 67TH AVE BLDG 100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853083612",
            "telephone_number": "623-979-2747",
            "fax_number": "623-979-3122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORINO",
        "first_name": "JORDAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-22",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "AZ",
            "license": "LPT-31675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "GLENDALE",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "GLENDALE",
            "address_1": "17100 N 67th Ave Bldg 100",
            "city": "GLENDALE",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853083612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; 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.