Individual provider Active NPI

Mark Zeppa, PT, DPT

  • Physical Therapist
  • Modesto, CA
National Provider Identifier
1902669534
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
305620 Issued in CA
Practice address
4028 Dale Rd Ste 101
Modesto, CA 95356-9561
Phone
(209) 312-9739
Fax
(209) 312-9747
NPI assigned
Feb 5, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 305620 CA Primary

Addresses

Primary practice location

4028 Dale Rd Ste 101
Modesto, CA 95356-9561

Mailing address

4028 Dale Rd Ste 101
Modesto, CA 95356-9561
Phone (209) 312-9739

Other practice location 1

3609 Oakdale Rd Ste 3
Modesto, CA 95357-0718
Phone (209) 312-9591

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240411001707 CA Practitioner - Physical Therapist in Private Practice 0244679140 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopedic Physical Therapy Institute, Inc.Group PAC ID 2264663822, 5 clinicians

Practice addresses (Care Compare)

4028 Dale Rd
Suite 101
Modesto, CA 95356-9561
Phone (209) 605-2771

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
305620CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Physical Therapy Institute, Inc. CurrentSince Feb 27, 2024 Accepting new patients

Locations

4028 Dale Rd
Ste 101
Modesto, CA 95356
Phone (209) 312-9739

3609 Oakdale Rd
Ste 3
Modesto, CA 95357
Phone (209) 312-9591

Organizations & group practices 1

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": "1707091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1902669534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4028 DALE RD STE 101",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569561",
            "telephone_number": "209-312-9739",
            "fax_number": "209-312-9747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4028 DALE RD STE 101",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569561",
            "telephone_number": "209-312-9739",
            "fax_number": "209-312-9747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3609 Oakdale Rd Ste 3",
            "address_purpose": "LOCATION",
            "city": "Modesto",
            "state": "CA",
            "postal_code": "953570718",
            "country_code": "US",
            "telephone_number": "209-312-9591",
            "fax_number": "209-661-4469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZEPPA",
        "first_name": "MARK",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-05",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "305620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.