Mary Pezzella, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

19904 Issued in CO

Practice address

2706 28TH St
Boulder, CO 80301-1222

Phone

(303) 444-1290

Fax

(303) 444-1837

NPI assigned

Apr 24, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Covell Care and Rehabilitation LLCGroup PAC ID 9335223429, 60 clinicians

Altitude Physical Therapy and Sports Medicine LLCGroup PAC ID 8628050267, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Altitude Physical Therapy & Sports Medicine LLC

  • Physical Therapy Clinic/Center
  • Wheat Ridge, CO
  • NPI 1548218241

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Covell Care and Rehabilitation, LLC

  • Home Health Agency
  • Windsor, CO
  • NPI 1063695351

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Panorama Orthopedics and Spine Center PC

  • Orthopaedic Surgery Physician
  • Golden, CO
  • NPI 1295787950
  Medicare reassignment NPD
• Panorama Orthopedics & Spine Center, PC

  • Physical Therapy Clinic/Center
  • Wheat Ridge, CO
  • NPI 1003574054
  NPD
• Panorama Orthopedics & Spine Center, PC

  • Physical Therapy Clinic/Center
  • Colorado Springs, CO
  • NPI 1194390518
  NPD
• Altitude Physical Therapy & Sports Medicine LLC

  • Physical Therapy Clinic/Center
  • Longmont, CO
  • NPI 1235729567
  NPD (past)

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

{
    "created_epoch": "1713916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1821844549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2706 28TH ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011222",
            "telephone_number": "303-444-1290",
            "fax_number": "303-444-1837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2706 28TH ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011222",
            "telephone_number": "303-444-1290",
            "fax_number": "303-444-1837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEZZELLA",
        "first_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-24",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "CP027484T",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "19904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ioanna Petropoulou, PSYCHD
• Katherine Helen Petty, PHD
• Stephanie Peverill
• Caitlin Pewthers
• Alexis Pezdek
• Sara Leilani Pfeifer
• Suzann Nichole Pfeifer, MS
• Jayson J Pfister
• PG Neuropsychology
• Khoa Dang Pham, LMT

• Physical Therapist in Boulder, CO
• Providers in Boulder, CO by specialty
• Physical Therapist in Colorado

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