Maynard Villavicencio Utayde, PT
NPI 1699832113ActiveIndividual· Physical Therapist· Mishawaka, IN
Physical Therapist (PT) with Theracare Inc, practicing in Mishawaka, Indiana. Enrolled in Medicare as practitioner - physical therapist in private practice.
Overview
| NPI | 1699832113 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PT |
| Sole proprietor | Yes |
| NPI issued | Jan 3, 2007 |
| Last updated in NPPES | Jul 17, 2016 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 05005198A | IN |
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 (IN) |
|---|
Education and affiliations
| Graduation year | 1994 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Theracare IncFishers, IN · 8 clinicians
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