EMERALD BAY PHYSICAL THERAPY PC
NPI 1275258485
Physical Medicine & Rehabilitation in South Lake Tahoe, CA

Active since October 10, 2022
812 EMERALD BAY RD, SOUTH LAKE TAHOE, CA 96150(530) 542-2662(530) 542-2661 Get Directions Write a Review

NPPES record last updated: December 28, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 1, 2022, Oct 10, 2022 (2 updates tracked since 2022).

About Emerald Bay Physical Therapy Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EMERALD BAY PHYSICAL THERAPY PC (NPI 1275258485) is a healthcare organization registered as a physical medicine & rehabilitation in South Lake Tahoe, California and active in the NPI registry since October 2022. The organization lists Stacey A Mullins, Biller/credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1275258485
Entity TypeOrganization
Primary Taxonomy208100000X
Legal Business NameEMERALD BAY PHYSICAL THERAPY PC
Location Address812 EMERALD BAY RDSouth Lake Tahoe, CA 96150-6413
Mailing Address812 Emerald Bay RdSouth Lake Tahoe, CA 96150-6413 · (530) 542-2662 · Fax (530) 542-2661
Fax(530) 542-2661
Organization SubpartNo
Authorized OfficialStacey A MullinsBiller/credentialing Specialist · (530) 314-3971
Enumeration DateOctober 10, 2022
Last NPPES UpdateDecember 28, 20232 updates tracked since enumeration
NPPES CertifiedDecember 28, 2023
✔ NPI 1275258485 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Medicine & RehabilitationAllopathic & Osteopathic Physicians
Taxonomy Code208100000X
Definition
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.
812 EMERALD BAY RD, South Lake Tahoe, CA 96150

Other Identifiers 1

Other12524419Caqh

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Emerald Bay Physical Therapy Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Emerald Bay Physical Therapy PC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Physical Therapist in Private Practice
NPI 1679853238
812 EMERALD BAY RD
S Lake Tahoe, CA 96150
(530) 542-2662
✔ Accepts MedicareSame address
Physical Therapist in Private Practice
NPI 1255707618
2877 LAKE TAHOE BLVD STE D
South Lake Tahoe, CA 96150
(530) 314-3249
✔ Accepts Medicare2.1 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Emerald Bay Physical Therapy PC's NPI number?

The NPI number for Emerald Bay Physical Therapy PC is 1275258485. It was assigned to this organization in the NPPES registry on October 10, 2022.

Where is Emerald Bay Physical Therapy PC located?

Emerald Bay Physical Therapy PC is located at 812 Emerald Bay Rd, South Lake Tahoe, CA 96150. The listed phone number is (530) 542-2662.

What is Emerald Bay Physical Therapy PC's specialty?

The primary specialty registered for this NPI is Physical Medicine & Rehabilitation with taxonomy code 208100000X.

Is Emerald Bay Physical Therapy PC enrolled in Medicare?

Yes. Emerald Bay Physical Therapy PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Emerald Bay Physical Therapy PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Physical Therapist in Private Practice, reassign their Medicare billing to Emerald Bay Physical Therapy PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Emerald Bay Physical Therapy PC was last updated on December 28, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.