Individual provider Active NPI

Pauline A Mahoney, PT

  • Physical Therapist
  • Fountain Hills, AZ
National Provider Identifier
1023027588
Registry record updated Feb 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5360 Issued in AZ
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

Updated by the provider on Feb 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
809494MedicaidAZ

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

LicenseStateTypeSpecialty
5360AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.