Pongratz Physical Therapy, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5241 Issued in AZ

Legal business name

PONGRATZ PHYSICAL THERAPY, LLC

Practice address

641 W Southern Ave
Mesa, AZ 85210-5004

Phone

(602) 222-3032

Fax

(480) 615-1117

NPI assigned

Dec 11, 2007

Organization subpart

No

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

Authorized official

Name

Anissa L Pongratz, MPTNPI 1649212135

Title

President/Owner

Phone

(602) 222-3032

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anissa L. Pongratz, MPT

  • Physical Therapist
  • Mesa, AZ
  • NPI 1649212135
  NPD (past) Authorized official

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197331200000",
    "number": "1982887113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "641 W SOUTHERN AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852105004",
            "telephone_number": "602-222-3032",
            "fax_number": "480-615-1117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "641 W SOUTHERN AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852105004",
            "telephone_number": "602-222-3032",
            "fax_number": "480-615-1117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONGRATZ PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-11",
        "last_updated": "2007-12-11",
        "status": "A",
        "authorized_official_last_name": "PONGRATZ",
        "authorized_official_first_name": "ANISSA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "602-222-3032",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "5241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PIN",
            "identifier": "81712",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "864399",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Pomfret, LMT
• Aime Andrea Poncho
• Jordan Pond, DMD
• Ponderosa Pine Healthcare, Inc.
• Pongratz Orthotics & Prosthetics, Inc.
• Anissa L. Pongratz, MPT
• Charli Poole, MS RD
• De'Carlos Poole
• Janelle Tyler Poole, FNP-C
• Melody Pope

• Physical Therapist in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.

Verify at the official NPI Registry.