Jose Marcelo E Souza Mafra, PT

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

License

PTL.0016237 Issued in CO

Practice address

102 S Bonaventure Ave
Trinidad, CO 81082-2054

Phone

(719) 846-8072

Fax

(710) 846-8071

NPI assigned

Mar 18, 2026

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

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": "1773792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1841148624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7620 GRIZZLY ROSE WAY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809235501",
            "telephone_number": "719-846-8072",
            "fax_number": "719-846-8071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 S BONAVENTURE AVE",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "810822054",
            "telephone_number": "719-846-8072",
            "fax_number": "710-846-8071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "E SOUZA MAFRA",
        "first_name": "JOSE",
        "middle_name": "MARCELO",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-18",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "CO",
            "license": "PTL.0016237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Geriatric Physical Therapist in Trinidad, CO
• Providers in Trinidad, CO by specialty
• Geriatric Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2026; 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.