Sport & Spine Therapy of Marin Inc
NPI 1174578199ActiveOrganization· Physical Therapist, Orthopedic· Novato, CA
Physical Therapist, Orthopedic in Novato, California, registered in NPPES in May 2006. The authorized official on file is Bobby Ismail, DPT, President. Enrolled in Medicare as part b supplier - physical/occupational therapy group in private practice.
Overview
| NPI | 1174578199 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 24, 2006 |
| Last updated in NPPES | Dec 6, 2023 |
| Certified by provider | Dec 6, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist, Orthopedic Primary | 2251X0800X | — | — |
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 (CA) |
|---|
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