Emerald Bay Physical Therapy PC
NPI 1275258485 · Physical Medicine & Rehabilitation Physician · South Lake Tahoe, CA
Enrolled with Medicare as Part B Supplier - Physical/Occupational Therapy Group in Private Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Emerald Bay Physical Therapy PC is a Physical Medicine & Rehabilitation Physician organization in South Lake Tahoe, CA (NPI 1275258485).
Provider details
- NPI number
- 1275258485
- Entity type
- Organization
- Primary specialty
- Physical Medicine & Rehabilitation PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Stacey Mullins, Biller/Credentialing Specialist(530) 314-3971
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2022-10-10
- Last updated
- 2023-12-28
- Certified
- 2023-12-28
Frequently asked questions
- What is Emerald Bay Physical Therapy PC's NPI number?
- Emerald Bay Physical Therapy PC's National Provider Identifier (NPI) is 1275258485, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Emerald Bay Physical Therapy PC?
- Emerald Bay Physical Therapy PC is classified in the NPPES registry as Physical Medicine & Rehabilitation Physician (Allopathic & Osteopathic Physicians).
- Where is Emerald Bay Physical Therapy PC located?
- Emerald Bay Physical Therapy PC's practice location on file with NPPES is 812 Emerald Bay Rd, South Lake Tahoe, CA 96150-6413.
- What is Emerald Bay Physical Therapy PC's phone number?
- The practice phone number listed in the NPPES registry for Emerald Bay Physical Therapy PC is (530) 542-2662.
- Does Emerald Bay Physical Therapy PC accept Medicare?
- Emerald Bay Physical Therapy PC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Emerald Bay Physical Therapy PC?
- The authorized official listed on Emerald Bay Physical Therapy PC's NPPES record is Stacey Mullins, Biller/Credentialing Specialist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Emerald Bay Physical Therapy PC's NPI active?
- Yes — Emerald Bay Physical Therapy PC's NPI (1275258485) is active in the NPPES registry as of the last update on 2023-12-28.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.