Individual provider Active NPI

Mason Staubus, DPT

  • Physical Therapist
  • Vandalia, OH
National Provider Identifier
1083538904
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT022561 Issued in OH
Practice address
810 Falls Creek Dr Ste B
Vandalia, OH 45377-8600
Phone
(937) 298-2584
NPI assigned
Aug 5, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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 PT022561 OH Primary

Addresses

Primary practice location

810 Falls Creek Dr Ste B
Vandalia, OH 45377-8600

Mailing address

53 Emery Dr
Bourbonnais, IL 60914-1067

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1785888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1083538904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 EMERY DR",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 FALLS CREEK DR STE B",
            "city": "VANDALIA",
            "state": "OH",
            "postal_code": "453778600",
            "telephone_number": "937-298-2584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAUBUS",
        "first_name": "MASON",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-08-05",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT022561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vandalia, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2026; 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.