STACIE PERICLOS P.T. NPI 1013359611

Physical Therapist (Pediatrics) in Vail, AZ

NPI 1013359611 Individual Female Physical Therapist Pediatrics

About STACIE PERICLOS

Stacie Periclos is a provider established in Vail, Arizona and her medical specialization is physical therapist (pediatrics) . The NPI number of Stacie Periclos is 1013359611 and was assigned on July 2013. The practitioner's primary taxonomy code is 2251P0200X with license number 2957 (AZ). The provider is registered as an individual and her NPI record was last updated 9 years ago.

Stacie Periclos is a non-participating provider of Medicare. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.

NPI

1013359611

Provider Name STACIE PERICLOS P.T.
Provider Location Address13801 E BENSON HWY VAIL, AZ 85641
Provider Mailing Address13801 E BENSON HWY VAIL, AZ 85641
GenderFemale
NPI Entity TypeIndividual
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date07-23-2013
Last Update Date07-23-2013


Primary Taxonomy

Taxonomy Code2251P0200X
ClassificationPhysical Therapist
TypeRespiratory, Developmental, Rehabilitative and Restorative Service Providers
SpecializationPediatrics
License No.2957
License StateAZ
Taxonomy DescriptionA licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Pediatric Physical Therapy, who has demonstrated specialized knowledge and skill in anatomy, histology, including embryonic development, genetics, biomechanics, neurological function, neuroscience, and pathology, behavioral sciences, and understanding of diseases or conditions that necessitate physical therapy care, that affect systems that in turn necessitate physical therapy care (comorbidities), and that influence the type of intervention that can be given.

Business Address

STACIE PERICLOS P.T.
13801 E BENSON HWY
VAIL, AZ
ZIP 85641
Phone: (520) 879-2052

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Mailing Address

STACIE PERICLOS P.T.
13801 E BENSON HWY
VAIL, AZ
ZIP 85641
Phone: (520) 879-2052



Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
1952438368MEDICAID (05)AZ

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1184735375MS. KELLEY K REDWINE OTR/L
Individual
Occupational Therapist13801 E BENSON HWY
VAIL, AZ 85641
(520) 879-2051
1649362252 MARY ELLEN L MACHAIN OTR
Individual
Occupational Therapist (Pediatrics)13801 E BENSON HWY
VAIL, AZ 85641
(520) 879-2000
1679623060DR. DEBORAH MCKINNEY DOUBRAVA PSY.D.
Individual
Psychologist (Clinical)13801 E BENSON HWY
VAIL, AZ 85641
(520) 444-9387
1295853638DR. SANDRA SAMUELSON THOMPSON PH.D.
Individual
Psychologist (School)13801 E BENSON HWY
VAIL, AZ 85641
(520) 879-2061
1669594321MS. DEBORAH SOWARD OT
Individual
Specialist13801 E BENSON HWY VAIL SCHOOL DISTRICT #20 SPECIAL EDUCATION OFFICE
VAIL, AZ 85641
(520) 762-2016
1275759300 JENNIFER LYNN GARCIA COTA
Individual
Occupational Therapy Assistant13801 E BENSON HWY
VAIL, AZ 85641
(719) 406-5593
1992921829DR. JENNIFER BRADEN KIRKPATRICK PH.D.
Individual
Psychologist (School)13801 E BENSON HWY VAIL UNIFIED SCHOOL DISTRICT
VAIL, AZ 85641
(520) 879-2440
1598984908MS. MAUREEN BRIDGET CORCORAN OTR
Individual
Specialist13801 E BENSON HWY
VAIL, AZ 85641
(520) 879-2086
1225258890MRS. DIANE CHRISTINE KENT SLP, B.A
Individual
Speech-Language Pathologist13801 E BENSON HWY
VAIL, AZ 85641
(520) 879-2074
1659585404 ADAM ROBERT GODFREY SSP, NASP
Individual
Psychologist (School)13801 E BENSON HWY
VAIL, AZ 85641
(520) 879-2440
1528278850 SHENEE CLAPPER
Individual
Speech-Language Pathologist13801 E BENSON HWY
VAIL, AZ 85641
(520) 879-2253
1801080759MRS. THERESA MARIA MARTINEZ B.S.; M.S.
Individual
Speech-Language Pathologist13801 E BENSON HWY
VAIL, AZ 85641
(520) 879-3647
1861671042MS. CYNTHIA COOLIDGE ED.S
Individual
Psychologist (School)13801 E BENSON HWY
VAIL, AZ 85641
(520) 879-2000
1376719161MRS. LOREEN ANN KLEINBERG M.S.
Individual
Speech-Language Pathologist13801 E BENSON HWY
VAIL, AZ 85641
(520) 879-2000
1356580583 SUSAN RENEE PICKERING L.P.C.
Individual
Counselor (Professional)13801 E BENSON HWY
VAIL, AZ 85641
(520) 250-4337
1164752366 SSUE STEER
Individual
Speech-Language Pathologist13801 E BENSON HWY
VAIL, AZ 85641
(520) 762-2011
1700192473 BRIAN SEWELL
Individual
Psychologist (School)13801 E BENSON HWY
VAIL, AZ 85641
(520) 879-2052
1841506177 JUDY KAY WREGE MSOTR/L
Individual
Occupational Therapist13801 E BENSON HWY
VAIL, AZ 85641
(520) 203-3681
1124387295 SHANNON MURPHY PT
Individual
Physical Therapist13801 E BENSON HWY
VAIL, AZ 85641
(520) 879-2084
1164857728 ANGELA CHRISTINE GARCIA SLPA
Individual
Specialist/Technologist (Speech-Language Assistant)13801 E BENSON HWY
VAIL, AZ 85641
(520) 879-2072

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.