Active NPI
Mark E Tate, MPT
- Physical Therapist
- San Diego, CA
National Provider Identifier
1952477705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT27239
- Practice address
- 3115 Ocean Front Walk
San Diego, CA 92109-8729 - Phone
- (858) 488-3597
- Fax
- (858) 488-3178
- NPI assigned
- Nov 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT27239 | CA | Primary |
Addresses
Primary practice location
3115 Ocean Front Walk
San Diego, CA 92109-8729
Mailing address
3639 Midway Dr Ste B286
San Diego, CA 92110-5254
Phone (858) 488-3597
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT27239 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stac Physical Therapy Pfi, Inc | Physical Therapist | Past | Accepting new patients |
| Personally Fit Inc | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Physical Therapist
- San Diego, CA
- NPI 1043390073
-
- Physical Therapist
- San Diego, CA
- NPI 1427703354
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1952477705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3639 MIDWAY DR STE B286",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921105254",
"telephone_number": "858-488-3597",
"fax_number": "858-488-3178"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3115 OCEAN FRONT WALK",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921098729",
"telephone_number": "858-488-3597",
"fax_number": "858-488-3178"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TATE",
"first_name": "MARK",
"middle_name": "E",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT27239",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.