DR. MARK ANDREW JAGODZINSKI (NPI# 1891732467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891732467 |
| Entity Type | Individual |
| Full Name | DR. MARK ANDREW JAGODZINSKI |
| Credential | PT |
| Practice Address |
12691 W Smokey Dr Ste 128 Surprise AZ 85378-3801 |
| Practice Telephone | 6232344171 |
| Practice Fax Number | 6232344173 |
| Mailing Telephone | 6232344171 |
| Mailing Fax Number | 6232344173 |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2020-03-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225100000X | Physical Therapist | 5576 | AZ | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 2251G0304X |
Physical Therapist Specialization: Geriatrics |
5576 | AZ | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 2251H1200X |
Physical Therapist Specialization: Hand |
5576 | AZ | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
5576 | AZ | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 2251S0007X |
Physical Therapist Specialization: Sports |
5576 | AZ | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
5576 | AZ | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 738792 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 15508 W Bell Rd, St 101, Pmb 210, Surprise, AZ 853742432 | 6232149661 | 6232149662 |
| Street Address |
12691 W SMOKEY DR STE 128 |
| City | SURPRISE |
| State | AZ |
| Zip Code | 85378-3801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366953549 | Rise Orthopedic and Sports Physical Therapy LLC | Physical Therapist | 12691 W Smokey Dr Ste 128, Surprise, AZ 85378-3801 | 2017-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467947101 | Destiny Springs Healthcare, LLC | Psychiatric Hospital | 17300 N. Dysart Road, Surprise, AZ 85378 | 2018-06-26 |
| 1881013480 | Amanda Brimlow | Specialist | 12425 West Bell Rd, Suite 200, Surprise, AZ 85378 | 2014-04-10 |
| 1598193104 | Kalin Marie Harding | Nurse Practitioner | 12425 W. Bell Rd., Suite 106, Suprise, AZ 85378 | 2013-10-16 |
| 1043651540 | Rachel Sara Herrin | Internal Medicine | 12665 W. Smokey Dr., #140, Surprise, AZ 85378 | 2013-07-12 |
| 1962756528 | Daniel Allen Dryer | Registered Nurse | 11607 W. Mingus Mt. Ct., Surprise, AZ 85378 | 2012-11-05 |
| 1124374715 | Rabeca Vatamaniuc | Home Health Aide | 11151 W Lily Mckinley Dr, Surprise, AZ 85378 | 2012-08-01 |
| 1710073457 | Arizona's Children Association | Clinic/Center | 11321 West Bell Road, Suite 401, Surprise, AZ 85378 | 2006-10-04 |
| 1538429121 | Sr Billing | Anesthesiology | 12361 W Bola Dr, Suite 109, Surprise, AZ 85378 | 2012-05-17 |
| 1457515579 | Madhuri Dhupati & Associates Md PC. | Clinic/Center | 12647 W Smokey Dr Ste 119, Surprise, AZ 85378 | 2008-07-17 |
| 1205267119 | Post-acute Physicians of Arizona Pllc | Physical Medicine & Rehabilitation | 13060 W Bell Rd, Surprise, AZ 85378-1200 | 2013-12-02 |
| Find all providers in zip 85378 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871979195 | Shea Kl Campbell | Physical Therapist | 15459 W. Bell Rd, Suite 107, Surprise, AZ 85374 | 2015-08-10 |
| 1598926800 | Stephen Douglas Dillon | Physical Therapist | 13995 W Statler Blvd Ste 165, Surprise, AZ 85374-5501 | 2008-06-19 |
| 1073610440 | Northwest Orthopedic & Sports Physical Therapy LLC | Physical Therapist | 14800 W Mountain View Blvd Ste 260, Surprise, AZ 85374-4797 | 2006-09-20 |
| 1366953549 | Rise Orthopedic and Sports Physical Therapy LLC | Physical Therapist | 12691 W Smokey Dr Ste 128, Surprise, AZ 85378-3801 | 2017-10-16 |
| 1942391032 | Scott E Peterson | Physical Therapist | 14800 W Mountain View Blvd, Suite 260, Surprise, AZ 85374-4795 | 2006-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578164505 | Imove Health LLC | Physical Therapist | 1054 S Fargo St, Chandler, AZ 85286-1078 | 2020-11-05 |
| 1457984841 | Caleb Lynch | Physical Therapist | 1055 N La Canada Dr Ste 123, Green Valley, AZ 85614-3700 | 2020-02-13 |
| 1790315992 | Kaylea Davis | Physical Therapist | 1675 E Melrose St, Gilbert, AZ 85297-1001 | 2020-01-16 |
| 1124667860 | Stephanie Laura Mundt | Physical Therapist | 10665 E Le Marche Dr, Scottsdale, AZ 85255-1925 | 2019-12-28 |
| 1932755808 | Nathanial David Phillips | Physical Therapist | 41125 N Daisy Mountain Dr Ste 121, Anthem, AZ 85086-4964 | 2019-08-15 |
| 1659937563 | Daniel Cooper | Physical Therapist | 20242 N 29th Pl, Phoenix, AZ 85050-4711 | 2019-05-15 |
| 1649836552 | Zachary Allen Cash | Physical Therapist | 20940 N Tatum Blvd Ste B290, Phoenix, AZ 85050-4265 | 2019-05-15 |
| 1578035630 | Premier Fitness Systems LLC | Physical Therapist | 7267 E Adobe Dr Ste 101, Scottsdale, AZ 85255-4032 | 2018-12-28 |
| 1053806729 | Melanie Topete | Physical Therapist | 2525 S Rural Rd Ste 5s, Tempe, AZ 85282-2444 | 2018-06-26 |
| 1104318344 | Freddy Ruiz Jr. | Physical Therapist | 2330 N 75th Ave Ste 113, Phoenix, AZ 85035-1200 | 2018-06-04 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. MARK ANDREW JAGODZINSKI.
| 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.