Mark Andrew Jagodzinski, PT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

5576 Issued in AZ

Practice address

12515 W Bell Rd Ste 103
Surprise, AZ 85378-9701

Phone

(623) 234-4171

Fax

(623) 234-4173

NPI assigned

Jun 1, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Modern Sports Medicine LLCGroup PAC ID 6800228479, 40 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.

• Modern Sports Medicine LLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Sun Lakes, AZ
  • NPI 1285295089

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Rise Orthopedic and Sports Physical Therapy LLC

  • Orthopedic Physical Therapist
  • Surprise, AZ
  • NPI 1366953549
  Medicare reassignment NPD Authorized official
• Modern Sports Medicine LLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Tucson, AZ
  • NPI 1609662709
  NPD
• Saguaro Health Care

  • Physical Therapist
  • Sun City West, AZ
  • NPI 1558440495
  NPD (past)

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1891732467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12515 W BELL RD STE 103",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853789701",
            "telephone_number": "623-234-4171",
            "fax_number": "623-234-4173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12515 W BELL RD STE 103",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853789701",
            "telephone_number": "623-234-4171",
            "fax_number": "623-234-4173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGODZINSKI",
        "first_name": "MARK",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "5576",
            "primary": false
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "AZ",
            "license": "5576",
            "primary": false
        },
        {
            "code": "2251H1200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Hand",
            "state": "AZ",
            "license": "5576",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "AZ",
            "license": "5576",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "AZ",
            "license": "5576",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "AZ",
            "license": "5576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "738792",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryne Jackson, DMD, MSD
• Hannah Jacobs, DOT
• Susan Andrea Jaffe, PT
• Kimberly Jager, FNP
• Emily Rose Jagodzinski
• Trace Jahner, M.S., CF-SLP
• James Care Associates LLC
• David F. James, DDS
• Kylie Delen James
• Tracey J James, LPC

• Orthopedic Physical Therapist in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Orthopedic Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; 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.