Mary A Mioux Berry, DO

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

20A8359 Issued in CA

Practice address

630 S Raymond Ave
Suite #120
Pasadena, CA 91105-3278

Phone

(626) 403-1444

Fax

(626) 403-1448

NPI assigned

Jun 27, 2005

Last updated

Oct 8, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Mary A Mioux Other name

Medicare fee-for-service enrollment

Enrolled in IL, CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physical Medicine and Rehabilitation

Education

At Still University of Health Sciences, College of Osteo Med, Kirksville, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cep America - Illinois SNF LLPGroup PAC ID 8022306737, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health Rehabilitation Hospital Inpatient rehabilitation facility, Richmond Heights, MO, CCN 263031
• The Rehabilitation Institute of Southern Illinois Inpatient rehabilitation facility, Shiloh, IL, CCN 143030

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cep America - Illinois SNF, LLP

  • Internal Medicine Physician
  • Belleville, IL
  • NPI 1073069415
  Medicare reassignment Care Compare group NPD
• Cep America - Illinois SNF LLP

  • Internal Medicine Physician
  • Edwardsville, IL
  • NPI 1043170434
  NPD
• Cep America - Illinois SNF, LLP

  • Internal Medicine Physician
  • Cahokia, IL
  • NPI 1104395441
  NPD
• Saint Anthonys Health Center

  • General Acute Care Hospital
  • Alton, IL
  • NPI 1528079027
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• SSM Select Rehab St Louis LLC

  • Rehabilitation Hospital
  • Richmond Heights, MO
  • NPI 1659511988

  Inpatient rehabilitation facility

  Care Compare affiliation
• The Rehabilitation Institute of Southern Illinois,LLC

  dba The Rehabilitation Institute of Southern Illinois

  • Rehabilitation Hospital
  • Shiloh, IL
  • NPI 1053088732

  Inpatient rehabilitation facility

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254960000000",
    "number": "1023014750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 S RAYMOND AVE",
            "address_2": "SUITE #120",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053278",
            "telephone_number": "626-403-1444",
            "fax_number": "626-403-1448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 S RAYMOND AVE",
            "address_2": "SUITE #120",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053278",
            "telephone_number": "626-403-1444",
            "fax_number": "626-403-1448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIOUX BERRY",
        "first_name": "MARY",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-27",
        "last_updated": "2009-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "036084547",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "20A8359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICAID",
            "identifier": "250004104",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0006005217",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "MIOUX",
            "middle_name": "A",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ashley Lauren Mink, LMFT
• Chris L Minnick, M.D.
• Nicole Minor
• Mint Health Solutions, Inc
• Mintwood Pharmacueticals, Inc. (Mintwood Pharmacy)
• Mohsen Mir, DDS
• Lisa Alexandra Mirabelli, PSY.D.
• Miracle Hearts Home Health Care, Inc.
• Elisabeth Miramontes, CPO
• Stephanie Nicole Miramontez

• Physical Medicine & Rehabilitation Physician in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.