Mark J. Brenner
NPI 1558764365ActiveIndividual· Physical Therapist· Fargo, ND
Physical Therapist with Professional Rehabilitation Center Inc, practicing in Fargo, North Dakota. Enrolled in Medicare as practitioner - physical therapist in private practice.
Overview
| NPI | 1558764365 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Oct 7, 2014 |
| Last updated in NPPES | Apr 6, 2022 |
| Certified by provider | Apr 6, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 0818 | ND |
| Physical Therapist, Orthopedic | 2251X0800X | 0818 | ND |
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 Practitioner - Physical Therapist in Private Practice (ND) |
|---|
Education and affiliations
| Graduation year | 1989 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Professional Rehabilitation Center IncFargo, ND · 12 clinicians
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