Physical Therapy & Sports Medicine of Northern New Mexico, Inc.
NPI 1306069224ActiveOrganization· Physical Therapist· Aztec, NM
Physical Therapist in Aztec, New Mexico, registered in NPPES in April 2007. The authorized official on file is Sid Mosiman, PT, Director. Enrolled in Medicare as part b supplier - physical/occupational therapy group in private practice.
Overview
| NPI | 1306069224 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 10, 2007 |
| Last updated in NPPES | Oct 7, 2025 |
| Certified by provider | Oct 7, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 1025 | NM |
| Physical Therapy Assistant | 225200000X | A-0483 | NM |
| Specialist/Technologist, Athletic Trainer | 2255A2300X | 108 | NM |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 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 (NM) |
|---|
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