Individual provider Active NPI

Casey Michael Mulligan, DPT

  • Physical Therapist
  • El Cerrito, CA
National Provider Identifier
1174094585
Registry record updated Dec 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT295859 Issued in CA
Practice address
425 Kearney St
El Cerrito, CA 94530-3656
Phone
(510) 524-2177
NPI assigned
Dec 10, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2018

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 PT295859 CA Primary

Addresses

Primary practice location

425 Kearney St
El Cerrito, CA 94530-3656

Mailing address

5123 Parkridge Dr
Oakland, CA 94619-3515

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190325002579 CA Practitioner - Physical Therapist in Private Practice 4284974429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Therapy Innovations IncGroup PAC ID 9537051743, 8 clinicians

Practice addresses (Care Compare)

425 Kearney St
El Cerrito, CA 94530-3656
Phone (510) 524-2177

Merit-based Incentive Payment System (MIPS)

Final score
94.3 of 100Reported as group
Quality
96.69
Improvement activities
40
Cost
82.3

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT295859CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Innovations, Inc. Physical Therapist CurrentSince Nov 8, 2018 Accepting new patients
Physical Therapy Innovations, Inc Physical Therapist CurrentSince Nov 8, 2018 Accepting new patients
Physical Therapy Innovations, Inc. Physical Therapist Past Accepting new patients

Locations

425 Kearney St
El Cerrito, CA 94530
Phone (510) 524-2177

1922 Webster St
Ste B
Oakland, CA 94612
Phone (510) 271-4793

122 Camino Pablo
Orinda, CA 94563
Phone (510) 524-2177

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": "1544400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544400000000",
    "number": "1174094585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5123 PARKRIDGE DR",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946193515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 KEARNEY ST",
            "city": "EL CERRITO",
            "state": "CA",
            "postal_code": "945303656",
            "telephone_number": "510-524-2177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIGAN",
        "first_name": "CASEY",
        "middle_name": "MICHAEL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-10",
        "last_updated": "2018-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT295859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Cerrito, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2018; 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.