MARY A MIOUX BERRY (NPI# 1023014750) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023014750 |
| Entity Type | Individual |
| Full Name | MARY A MIOUX BERRY |
| Other Name | MARY A MIOUX |
| Credential | DO |
| Practice Address |
630 S Raymond Ave Suite #120 Pasadena CA 91105-3278 |
| Practice Telephone | 6264031444 |
| Practice Fax Number | 6264031448 |
| Mailing Telephone | 6264031444 |
| Mailing Fax Number | 6264031448 |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2009-10-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208100000X | Physical Medicine & Rehabilitation | 20A8359 | CA | Allopathic & Osteopathic Physicians |
| N | 208100000X | Physical Medicine & Rehabilitation | 036084547 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS BLUE SHIELD | 0006005217 | 01 |
| IL | RAILROAD MEDICAID | 250004104 | 01 |
| Street Address |
630 S RAYMOND AVE SUITE #120 |
| City | PASADENA |
| State | CA |
| Zip Code | 91105-3278 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295249225 | Tracy Le Henry | Nurse Practitioner | 630 S Raymond Ave, Pasadena, CA 91105-3278 | 2017-11-29 |
| 1316493737 | Asa Maria Albecz | Technician, Other | 630 S Raymond Ave, #310, Pasadena, CA 91105-3278 | 2016-08-26 |
| 1023564481 | Neurologicinc | Specialist/Technologist, Other | 630 S Raymond Ave, Pasadena, CA 91105-3278 | 2016-08-26 |
| 1720475825 | Neuro-rehab Consultation & Treatment Services | Psychologist | 630 S Raymond Ave, #340, Pasadena, CA 91105-3278 | 2015-04-16 |
| 1215365747 | Roxanne Prilutsky, Ph.d., A Psychology Corporation | Psychologist | 630 S Raymond Ave, Suite 310, Pasadena, CA 91105-3278 | 2013-10-18 |
| 1467897322 | West Coast Neurology | Psychiatry & Neurology | 630 S Raymond Ave, Suite 310, Pasadena, CA 91105-3278 | 2013-05-06 |
| 1588943682 | Southern California Glaucoma Consultants Medical Group | Ophthalmology | 630 S Raymond Ave, 230, Pasadena, CA 91105-3278 | 2011-08-08 |
| 1376867309 | Valley Diagnostic Imaging Medical Group Inc | Specialist | 630 S Raymond Ave, Unit 210, Pasadena, CA 91105-3278 | 2010-03-19 |
| 1033431127 | Imaging Specialist of Pasadena LLC | Specialist | 630 S Raymond Ave, Unit 210, Pasadena, CA 91105-3278 | 2010-02-17 |
| 1245561752 | Elisa C Alvarado Md Inc | Internal Medicine | 630 S Raymond Ave, Suite 340, Pasadena, CA 91105-3278 | 2010-01-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619451697 | Tonya Michlin | Registered Nurse | 800 Fairmount Ave Ste 110, Pasadena, CA 91105 | 2018-09-17 |
| 1639674161 | David Marcus Md, Inc. | Psychiatry & Neurology | 107 S. Fair Oaks Avenue, Suite #315, Pasadena, CA 91105 | 2018-03-27 |
| 1548778541 | Elias & Jun Dental Corp | Dentist | 301 S. Fair Oaks Ave., Ste 107, Pasadena, CA 91105 | 2018-01-12 |
| 1013429745 | Whitney Catalano | Dietitian, Registered | 100 S Orange Grove Blvd, 103, Pasadena, CA 91105 | 2017-11-03 |
| 1518485630 | Marlon O Miller | Counselor | 1020 South Arroyo Parkway, Pasadena, CA 91105 | 2017-09-08 |
| 1316469976 | Alexandra Scott | Speech-Language Pathologist | 235 La Vereda Road, Pasadena, CA 91105 | 2017-07-14 |
| 1346770443 | Amanda Grace Gentz | Rehabilitation Practitioner | 210 S De Lacey, Ste 110, Pasadena, CA 91105 | 2017-06-13 |
| 1427598390 | Melina Gomez Loza | Licensed Vocational Nurse | 66 Hilburt St #2, Pasadena, CA 91105 | 2017-02-27 |
| 1588115281 | Ramon Banuelos | Rehabilitation Practitioner | 210 S. Delacey Ave Suite 110, Pasadena, CA 91105 | 2016-10-18 |
| 1922554245 | Daniel Joseph Ybarra | Student in an Organized Health Care Education/Training Program | 100 W. California Blvd. Pasadena, Ca 91105, Pasadena, CA 91105 | 2016-08-28 |
| Find all providers in zip 91105 | ||||
| Taxonomy Code | 208100000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Physical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and treating patients with physical disabilities. These disabilities may arise from conditions affecting the musculoskeletal system such as neck and back pain, sports injuries, or other painful conditions affecting the limbs, such as carpal tunnel syndrome. Alternatively, the disabilities may result from neurological trauma or disease such as spinal cord injury, head injury or stroke. A physician certified in physical medicine and rehabilitation is often called a physiatrist. The primary goal of the physiatrist is to achieve maximal restoration of physical, psychological, social and vocational function through comprehensive rehabilitation. Pain management is often an important part of the role of the physiatrist. For diagnosis and evaluation, a physiatrist may include the techniques of electromyography to supplement the standard history, physical, x-ray and laboratory examinations. The physiatrist has expertise in the appropriate use of therapeutic exercise, prosthetics (artificial limbs), orthotics and mechanical and electrical devices. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. American Osteopathic Board of Physical Medicine and Rehabilitation, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Physical Medicine and Rehabilitation. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801412002 | Kwasi Nkansa | Physical Medicine & Rehabilitation | 2585 East Washington Blvd, Pasadena, CA 91107 | 2020-06-23 |
| 1184068926 | Naveed M Natanzi | Physical Medicine & Rehabilitation | Synovation Medical Group, 1017 S. Fair Oaks Avenue, Pasadena, CA 91105 | 2013-04-23 |
| 1306116041 | Ivy Medical Associates Inc | Physical Medicine & Rehabilitation | 2309 Paloma St, Pasadena, CA 91104-4926 | 2012-01-11 |
| 1457642795 | Lysander Jim | Physical Medicine & Rehabilitation | 452 N Altadena Dr Unit 200, Pasadena, CA 91107-2536 | 2011-04-20 |
| 1376858829 | Christopher Tri Bui | Physical Medicine & Rehabilitation | 227 S Catalina Ave Unit 7, Pasadena, CA 91106-5004 | 2010-08-09 |
| 1013233576 | Mauro Walsh Zappaterra | Physical Medicine & Rehabilitation | 1035 S Fair Oaks Ave Ste 103, Institute for Regenerative Medicine & Clinical Research, Pasadena, CA 91105-2699 | 2010-04-08 |
| 1902065642 | Maureen Amber Tyson | Physical Medicine & Rehabilitation | 2693 E Washington Blvd, Pasadena, CA 91107-1412 | 2008-06-06 |
| 1003811340 | Sunil Kumar Hegde | Physical Medicine & Rehabilitation | 630 S. Raymond Ave., Suite #120, Pasadena, CA 91105 | 2005-06-14 |
| 1629676184 | Allyson M Andreini | Physical Medicine & Rehabilitation | 800 S Raymond Ave, Pasadena, CA 91105-3229 | 2020-10-15 |
| 1922578814 | Marissa Jong | Physical Medicine & Rehabilitation | 959 E Walnut St Ste 240, Pasadena, CA 91106-5348 | 2018-12-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.