Individual provider Active NPI

Allison Mark

  • Physical Therapist
  • Philadelphia, PA
National Provider Identifier
1740929025
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT030958 Issued in PA
Practice address
9475 Roosevelt Blvd # B4
Philadelphia, PA 19114-2212
Phone
(215) 464-6200
Fax
(215) 464-9834
NPI assigned
Jun 3, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PA
Orthopedic Physical Therapist 2251X0800X 40QA02091200 NJ
Physical Therapist 225100000X PT030958 PA Primary

Addresses

Primary practice location

9475 Roosevelt Blvd # B4
Philadelphia, PA 19114-2212

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other practice location 1

1930 S Broad St Ste J
Philadelphia, PA 19145-2328
Phone (267) 996-3900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220610002104 NJ Practitioner - Physical Therapist in Private Practice 0941688451
I20221227002127 PA Practitioner - Physical Therapist in Private Practice 0941688451 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
86.05 of 100Reported as group
Quality
89.12
Improvement activities
40
Cost
73.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT030958PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic and Sports Physical Therapy Services, Inc. Physical Therapist CurrentSince Dec 9, 2022 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Apr 16, 2024 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Apr 16, 2024 Accepting new patients
Progress Physical Therapy LLC Physical Therapist CurrentSince Dec 9, 2022 Accepting new patients
Ipta Clinical, LLC Physical Therapist CurrentSince Nov 1, 2023 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

11 Cadillac Rd
Burlington, NJ 08016
Phone (609) 880-0880

1919 Greentree Rd
Ste B
Cherry Hill, NJ 08003
Phone (856) 424-0993

1311 Mamaroneck Ave
Ste 140
White Plains, NY 10605
Phone (914) 265-4838

1175 Lancaster Ave
Berwyn, PA 19312
Phone (610) 651-8282

9475 Roosevelt Blvd
Philadelphia, PA 19114
Phone (215) 464-6200

9475 Roosevelt Blvd
#B4
Philadelphia, PA 19114
Phone (215) 464-6200

1930 S Broad St
Ste J
Philadelphia, PA 19145
Phone (267) 507-7572

118 Townsedge Dr
Quarryville, PA 17566
Phone (717) 806-5126

Organizations & group practices 5

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": "1654214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1740929025",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9475 ROOSEVELT BLVD # B4",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191142212",
            "telephone_number": "215-464-6200",
            "fax_number": "215-464-9834"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1930 S Broad St Ste J",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191452328",
            "country_code": "US",
            "telephone_number": "267-996-3900",
            "fax_number": "267-507-7572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARK",
        "first_name": "ALLISON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-03",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NJ",
            "license": "40QA02091200",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT030958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; 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.