Individual provider Active NPI

Mark Snyder, P.T.

  • Physical Therapist
  • Pleasanton, CA
National Provider Identifier
1982639662
Registry record updated Mar 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8788 Issued in CA
Practice address
5000 Pleasanton Ave
Suite 200
Pleasanton, CA 94566-7052
Phone
(925) 600-7033
Fax
(925) 600-7035
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2010

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 8788 CA Primary

Addresses

Primary practice location

5000 Pleasanton Ave
Suite 200
Pleasanton, CA 94566-7052

Mailing address

5000 Pleasanton Ave
Suite 200
Pleasanton, CA 94566-7052
Phone (925) 600-7033

Other identifiers 1

IdentifierTypeStateIssuer
00PT87880OtherCABLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040616000393 CA Practitioner - Physical Therapist in Private Practice 7012991193 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8788CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bass Medical Group Current Accepting new patients
Bass Medical Group CurrentSince May 31, 2018 Accepting new patients
Bass Medical Group CurrentSince May 31, 2018 Accepting new patients
Bass Medical Group Past Accepting new patients

Locations

1505 Saint Alphonsus Way
Alamo, CA 94507
Phone (925) 837-4225

5000 Pleasanton Ave
Ste 200
Pleasanton, CA 94566
Phone (510) 793-6655

5924 Stoneridge Dr
Ste 202
Pleasanton, CA 94588
Phone (925) 600-7020

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IBDGCA

Organizations & group practices 4

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269561600000",
    "number": "1982639662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 PLEASANTON AVE",
            "address_2": "SUITE 200",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945667052",
            "telephone_number": "925-600-7033",
            "fax_number": "925-600-7035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 PLEASANTON AVE",
            "address_2": "SUITE 200",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945667052",
            "telephone_number": "925-600-7033",
            "fax_number": "925-600-7035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "MARK",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2010-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "8788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00PT87880",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2010; 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.