Physical Therapy & Sports Medicine Of Northern New Mexico, Inc. in Aztec, NM

Physical Therapy & Sports Medicine Of Northern New Mexico, Inc. is a medicare enrolled "Physical Therapist" provider in Aztec, New Mexico. Their current practice location is 505 N Main Ave, Aztec, New Mexico. You can reach out to their office (for appointments etc.) via phone at (505) 334-9616.

Physical Therapy & Sports Medicine Of Northern New Mexico, Inc. is licensed to practice in New Mexico (license number 1025) and it also participates in the medicare program. Physical Therapy & Sports Medicine Of Northern New Mexico, Inc. is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1306069224.

Contact Information

	Physical Therapy & Sports Medicine Of Northern New Mexico, Inc.
	505 N Main Ave, Aztec, NM 87410-1942
	(505) 334-9616
	(505) 334-7343

Map and Direction

Healthcare Provider's Profile

Full Name	Physical Therapy & Sports Medicine Of Northern New Mexico, Inc.
Type	Facility
Speciality	Physical Therapist
Location	505 N Main Ave, Aztec, New Mexico
Accepts Medicare Assignments	Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs.

NPI Data:

NPI Number: 1306069224
Provider Enumeration Date: 04/10/2007
Last Update Date: 10/07/2025

Medicare PECOS Information:

PECOS PAC ID: 1951401785
Enrollment ID: O20070710000300

Medical Identifiers

Medical identifiers for Physical Therapy & Sports Medicine Of Northern New Mexico, Inc. such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1306069224	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	1025 (New Mexico)	Primary
225200000X	Physical Therapy Assistant	A-0483 (New Mexico)	Secondary
2255A2300X	Specialist/technologist - Athletic Trainer	108 (New Mexico)	Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Physical Therapy & Sports Medicine Of Northern New Mexico, Inc. acts as a billing entity for following providers:

Provider Name	Sid S Mosiman
Provider Type	Practitioner - Physical Therapist In Private Practice
Provider Identifiers	NPI Number: 1871667089 PECOS PAC ID: 7911007745 Enrollment ID: I20070710000359

Provider Name	Matthew V Fernandez
Provider Type	Practitioner - Physical Therapist In Private Practice
Provider Identifiers	NPI Number: 1851001077 PECOS PAC ID: 9931562071 Enrollment ID: I20230823000316

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Physical Therapy & Sports Medicine Of Northern New Mexico, Inc. is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Physical Therapy & Sports Medicine Of Northern New Mexico, Inc. 505 N Main Ave, Aztec, NM 87410-1942 Ph: (505) 334-9616	Physical Therapy & Sports Medicine Of Northern New Mexico, Inc. 505 N Main Ave, Aztec, NM 87410-1942 Ph: (505) 334-9616

Reviews and Comments

Physical Therapist in Aztec, NM

Margaret Irene Gores, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 505 N Main Ave, Aztec, NM 87410 Phone: 505-334-9616 Fax: 505-334-7343
Gordon Henriksen, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1607 W Aztec Blvd, Aztec, NM 87410 Phone: 505-334-3695
Carson Jay Collins, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 505 N Main Ave, Aztec, NM 87410 Phone: 505-334-9616
Matthew Vidal Fernandez, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 505 N Main Ave, Aztec, NM 87410 Phone: 505-334-9616
Mr. Sid Mosiman, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 505 N Main Ave, Aztec, NM 87410 Phone: 505-334-9616 Fax: 505-334-7343

Physical Therapy & Sports Medicine Of Northern New Mexico, Inc. - Medicare Physical Therapist in Aztec, NM