Mark J Coglianese, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-2916 Issued in ID

Practice address

217 N 2ND E
Rexburg, ID 83440-1621

Phone

(208) 359-6127

Fax

(208) 359-6127

NPI assigned

Jul 30, 2006

Last updated

Dec 19, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1999

Medicare assignment

May accept Medicare assignment

Group practices

Spine and Sport Pysical Therapy PCGroup PAC ID 5799772380, 4 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Spine and Sport Pysical Therapy PC

  • Physical Therapist
  • Rexburg, ID
  • NPI 1992975825
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766102400000",
    "number": "1912912791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "544 GOLDEN WILLOW DR",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834405270",
            "telephone_number": "084-031-5052",
            "fax_number": "083-596-1272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 N 2ND E",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401621",
            "telephone_number": "208-359-6127",
            "fax_number": "208-359-6127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COGLIANESE",
        "first_name": "MARK",
        "middle_name": "J",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-30",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-2916",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "1375",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1912912791",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1912912791",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "REXBURG",
            "affiliation": "Y",
            "affiliationName": "Spine and Sport Pysical Therapy PC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "SECURE EMAIL",
            "address_1": "217 N 2nd E",
            "city": "Rexburg",
            "state": "ID",
            "country_code": "US",
            "postal_code": "834401621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physical Therapist in Rexburg, ID
• Providers in Rexburg, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2025; 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.