Braden J Mengarelli, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

LPT-31673 Issued in AZ

Practice address

1983 Commerce Center Cir
Prescott, AZ 86301-4454

Phone

(928) 771-1700

Fax

(928) 771-9900

NPI assigned

Mar 25, 2021

Last updated

Mar 26, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in AZ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Freedom Performance, LLC

  • Sports Physical Therapist
  • Prescott, AZ
  • NPI 1922778307
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1821675836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1983 COMMERCE CENTER CIR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863014454",
            "telephone_number": "928-771-1700",
            "fax_number": "928-771-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1983 COMMERCE CENTER CIR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863014454",
            "telephone_number": "928-771-1700",
            "fax_number": "928-771-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENGARELLI",
        "first_name": "BRADEN",
        "middle_name": "J",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-25",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-31673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary Robert Melvin, M.D.
• Men's Counseling Services LLC
• Nicolas John Mencarini
• Zachary Mendenhall, LMT
• Angel Jose Mendez, PHARMD
• Mental Mending Counseling
• Tana Merino, LMT
• Phil Merrell, M.ED. LAC.
• Merrill Enterprises, Inc (Prescott Pediatric Occupational Therapy; Second Sight Vision Rehab)
• David Merrill, D.O.

• Physical Therapist in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.