Phoenix Mountain Therapy LLC
NPI 1053122689ActiveOrganization· Physical Therapist· Scottsdale, AZ
Physical Therapist in Scottsdale, Arizona, registered in NPPES in January 2025. The authorized official on file is Soon Burnam, Secretary. Enrolled in Medicare as part b supplier - physical/occupational therapy group in private practice.
Overview
| NPI | 1053122689 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 14, 2025 |
| Last updated in NPPES | Feb 10, 2026 |
| Certified by provider | Feb 10, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
| Occupational Therapist | 225X00000X | — | — |
| Speech-Language Pathologist | 235Z00000X | — | — |
| Clinic/Center, Rehabilitation | 261QR0400X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Physical/Occupational Therapy Group in Private Practice (AZ) |
|---|
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All 637 physical therapists in Scottsdale · All physical therapists in Arizona