Mia Manzanares Baeza, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11457 Issued in LA

Practice address

4027 I 49 S Service Rd
Opelousas, LA 70570-0757

Phone

(337) 948-4212

Fax

(337) 942-9979

NPI assigned

Mar 27, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1942904933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1326 CHURCH ST",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707912743",
            "telephone_number": "225-654-8208",
            "fax_number": "225-654-4642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4027 I 49 S SERVICE RD",
            "city": "OPELOUSAS",
            "state": "LA",
            "postal_code": "705700757",
            "telephone_number": "337-948-4212",
            "fax_number": "337-942-9979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAEZA",
        "first_name": "MIA",
        "middle_name": "MANZANARES",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "11457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOUISIANA PHYSICAL THERAPY BOARD",
            "identifier": "11457",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Babineaux
• Laurie Babineaux
• Damian Badeaux, MD
• Jordan Badeaux
• Stacie Badeaux
• Barbara Pearce Bailey, OD
• Elpidia H Balbastro, M.D.
• Gerard A. Ballanco Jr., M.D.
• Tara Banks, MENTAL HEALTH SPEC.
• John Dwayne Baque, RPH

• Physical Therapist in Opelousas, LA
• Providers in Opelousas, LA by specialty
• Physical Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; 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.