Proactive Physical and Aquatic

Primary specialty

SpecialistTaxonomy code 174400000X

License

0087104 Issued in AZ

Legal business name

PROACTIVE PHYSICAL AND AQUATIC

Practice address

9746 N 90TH PL
Suite 103
Scottsdale, AZ 85258-5083

Phone

(480) 443-3534

Fax

(480) 367-9515

NPI assigned

Dec 11, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Mindi G Bloomenstein, P.T.NPI 1740280908

Title

Physical Therapist

Phone

(480) 443-3534

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mindi G Bloomenstein, PT

  • Physical Therapist
  • Scottsdale, AZ
  • NPI 1740280908
  Medicare reassignment NPD Authorized official
• Charina A Bloomenstein, PT

  • Physical Therapist
  • Scottsdale, AZ
  • NPI 1114927407
  Medicare reassignment NPD

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302566400000",
    "number": "1912067976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9746 N 90TH PL",
            "address_2": "SUITE 103",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852585083",
            "telephone_number": "480-443-3534",
            "fax_number": "480-367-9515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9746 N 90TH PL",
            "address_2": "SUITE 103",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852585083",
            "telephone_number": "480-443-3534",
            "fax_number": "480-367-9515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE PHYSICAL AND AQUATIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2011-04-12",
        "status": "A",
        "authorized_official_last_name": "BLOOMENSTEIN",
        "authorized_official_first_name": "MINDI",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "480-443-3534",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "AZ",
            "license": "0087104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Process of Thought Psychiatric Services
• Jennifer Lynn Prochniewski, PA-C
• Professional Natural Medical
• Tiffany Robin Proffitt, D.O.
• Proformance Health LLC

• Specialist in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Specialist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.