Individual provider Active NPI

Jason Peter Mohacey, MSPT

  • Physical Therapist
  • Milford, DE
National Provider Identifier
1104805894
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
J1-0002057 Issued in DE
Practice address
100 Silicato Pkwy Ste 105
Milford, DE 19963-1271
Phone
(302) 265-3744
NPI assigned
Jan 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X PT017504 PA
Physical Therapist 225100000X J1-0002057 DE Primary

Addresses

Primary practice location

100 Silicato Pkwy Ste 105
Milford, DE 19963-1271

Mailing address

PO Box 392573
Pittsburgh, PA 15251-9573

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060504000426 DE Practitioner - Physical Therapist in Private Practice 3274576798 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

230 Beiser Blvd
Suite 103
Dover, DE 19904-7791
Phone (302) 672-0293

4001 Miller Rd
Wilmington, DE 19802-1961
Phone (302) 764-2008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Rehabilitation and Health Services of Delaware Inc Physical Therapist CurrentSince Jan 31, 2017 Accepting new patients
Phoenix Rehabilitation and Health Services of Delaware Inc Physical Therapist CurrentSince Oct 13, 2024 Accepting new patients
Shore Movement Physical Therapy, P.a. Physical Therapist PastSince May 8, 2006 Accepting new patients
Ft. Washington Rehabilitation & Fitness Center, Inc. Specialist Past Accepting new patients

Locations

230 Beiser Blvd
Ste 103
Dover, DE 19904
Phone (302) 672-0293

100 Silicato Pkwy
Ste 105
Milford, DE 19963
Phone (302) 265-3744

401 S DuPont Blvd
Ste 7
Milford, DE 19963
Phone (302) 725-5720

4001 Miller Rd
Wilmington, DE 19802
Phone (302) 764-2008

8215 W 108th Ter
Overland Park, KS 66210

Organizations & group practices 4

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": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1104805894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 392573",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152519573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SILICATO PKWY STE 105",
            "city": "MILFORD",
            "state": "DE",
            "postal_code": "199631271",
            "telephone_number": "302-265-3744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHACEY",
        "first_name": "JASON",
        "middle_name": "PETER",
        "name_prefix": "Mr.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "PT017504",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "J1-0002057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milford, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.