Adult and Pediatric Rehabilitation
NPI 1114274784ActiveOrganization· Physical Therapist· San Luis, AZ
Physical Therapist in San Luis, Arizona, registered in NPPES in August 2012. The authorized official on file is Sergio Ivan Macias, P.T., Owner. Enrolled in Medicare as dme supplier - independently-practicing physical therapist and part b supplier - physical/occupational therapy group in private practice.
Overview
| NPI | 1114274784 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 13, 2012 |
| Last updated in NPPES | Apr 1, 2024 |
| Certified by provider | Sep 7, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 4229 | AZ |
| Durable Medical Equipment & Medical Supplies | 332B00000X | C001071 | AZ |
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 DME Supplier - Independently-Practicing Physical Therapist (AZ); Part B Supplier - Physical/Occupational Therapy Group in Private Practice (AZ) |
|---|
Other Physical Therapist providers in San Luis
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