Active NPI
Pauline A Mahoney, PT
- Physical Therapist
- Fountain Hills, AZ
National Provider Identifier
1023027588
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5360
- Practice address
- 16838 E Palisades Blvd Ste B121
Fountain Hills, AZ 85268-3789 - Phone
- (480) 837-2595
- Fax
- (480) 837-2773
- NPI assigned
- Aug 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5360 | AZ | Primary |
Addresses
Primary practice location
16838 E Palisades Blvd Ste B121
Fountain Hills, AZ 85268-3789
Mailing address
9097 E Desert Cove Ave Ste 110
Scottsdale, AZ 85260-6276
Phone (480) 551-4967
Other practice location 1
9097 E Desert Cove Ave Ste 110
Scottsdale, AZ 85260-6276
Phone (480) 860-4298
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 809494 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5360 | AZ | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maximum Potential Sport & Fitness Training Inc. | Past | Accepting new patients | |
| KC'S Physical Therapy LLC | Past | Accepting new patients | |
| Saguaro Health Care | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Orthopedic Physical Therapist
- Phoenix, AZ
- NPI 1578592705
-
- Physical Therapy Clinic/Center
- Phoenix, AZ
- NPI 1558429860
-
- Physical Therapist
- Sun City West, AZ
- NPI 1558440495
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581897600000",
"number": "1023027588",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9097 E DESERT COVE AVE STE 110",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852606276",
"telephone_number": "480-551-4967",
"fax_number": "480-860-0356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16838 E PALISADES BLVD STE B121",
"city": "FOUNTAIN HILLS",
"state": "AZ",
"postal_code": "852683789",
"telephone_number": "480-837-2595",
"fax_number": "480-837-2773"
}
],
"practiceLocations": [
{
"address_1": "9097 E Desert Cove Ave Ste 110",
"address_purpose": "LOCATION",
"city": "Scottsdale",
"state": "AZ",
"postal_code": "852606276",
"country_code": "US",
"telephone_number": "480-860-4298",
"fax_number": "480-860-0165",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MAHONEY",
"first_name": "PAULINE",
"middle_name": "A",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-05",
"last_updated": "2020-02-17",
"certification_date": "2020-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "5360",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "809494",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fountain Hills, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.