Individual provider Active NPI

Mark Stephen Plante, P.T.

  • Physical Therapist
  • Yuma, AZ
National Provider Identifier
1982602827
Registry record updated Nov 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2608 Issued in AZ
Practice address
381 S Main St
Yuma, AZ 85364-2340
Phone
(928) 580-5769
Fax
(928) 782-1019
NPI assigned
Jul 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2007

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 2608 AZ Primary

Addresses

Primary practice location

381 S Main St
Yuma, AZ 85364-2340

Mailing address

381 S Main St
Yuma, AZ 85364-2340
Phone (928) 580-5769

Other identifiers 2

IdentifierTypeStateIssuer
AZ0460990OtherAZBLUE CROSS BLUE SHIELD ID
690330MedicaidAZ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040811000948 AZ Practitioner - Physical Therapist in Private Practice 8527030386 Practice locations: Yuma, AZ

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

381 S Main St
Yuma, AZ 85364-2340
Phone (928) 343-7828

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2608AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mark S. Plante PastSince Jan 1, 1990 Accepting new patients

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": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196208000000",
    "number": "1982602827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "381 S MAIN ST",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853642340",
            "telephone_number": "928-580-5769",
            "fax_number": "928-782-1019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "381 S MAIN ST",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853642340",
            "telephone_number": "928-580-5769",
            "fax_number": "928-782-1019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLANTE",
        "first_name": "MARK",
        "middle_name": "STEPHEN",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2007-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "2608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD ID",
            "identifier": "AZ0460990",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "690330",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; 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.