Emerald Bay Physical Therapy PC
NPI 1275258485ActiveOrganization· Physical Medicine & Rehabilitation· South Lake Tahoe, CA
Physical Medicine & Rehabilitation in South Lake Tahoe, California, registered in NPPES in October 2022. The authorized official on file is Stacey A. Mullins, Biller/Credentialing Specialist. Enrolled in Medicare as part b supplier - physical/occupational therapy group in private practice.
Overview
| NPI | 1275258485 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 10, 2022 |
| Last updated in NPPES | Dec 28, 2023 |
| Certified by provider | Dec 28, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Medicine & Rehabilitation Primary | 208100000X | — | — |
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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