Individual provider Active NPI

Mark Danial, DPT, OCS

  • Orthopedic Physical Therapist
  • Eagle Rock, CA
National Provider Identifier
1992106454
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
37996 Issued in CA
Practice address
2560 Colorado Blvd
Eagle Rock, CA 90041-1005
Phone
(323) 255-5409
Fax
(323) 255-5732
NPI assigned
Sep 15, 2014
Last updated
May 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 37996 CA Primary

Addresses

Primary practice location

2560 Colorado Blvd
Eagle Rock, CA 90041-1005

Mailing address

2560 Colorado Blvd
Eagle Rock, CA 90041-1005
Phone (323) 255-5409

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250305002325 CA Practitioner - Physical Therapist in Private Practice 2769903855 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
California Luna Care Physical Therapy PCGroup PAC ID 9638427834, 769 clinicians

Practice addresses (Care Compare)

16185 Los Gatos Blvd
Suite 205
Los Gatos, CA 95032-4569
Phone (866) 525-3175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37996CAMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Feb 3, 2025 Accepting new patients
California Luna Care Physical Therapy PC Orthopedic CurrentSince May 27, 2025 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Feb 3, 2025 Accepting new patients

Locations

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 409-4167

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

888 S Hill Rd
Ventura, CA 93003
Phone (805) 477-6400

5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1410739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1992106454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2560 COLORADO BLVD",
            "city": "EAGLE ROCK",
            "state": "CA",
            "postal_code": "900411005",
            "telephone_number": "323-255-5409",
            "fax_number": "323-255-5732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 COLORADO BLVD",
            "city": "EAGLE ROCK",
            "state": "CA",
            "postal_code": "900411005",
            "telephone_number": "323-255-5409",
            "fax_number": "323-255-5732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIAL",
        "first_name": "MARK",
        "credential": "DPT, OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-15",
        "last_updated": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "37996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5601 De Soto Ave",
            "city": "Woodland Hills",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913676701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Eagle Rock, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2025; 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.