Individual provider Active NPI

Mikayla Anne Mignogna

  • Student in an Organized Health Care Education/Training Program
  • Altoona, PA
National Provider Identifier
1205628971
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
3000 Fairway Dr
Altoona, PA 16602-4472
Phone
(814) 231-2101
Fax
(814) 231-8569
NPI assigned
May 20, 2025
Last updated
May 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary
Physical Therapist 225100000X NU

Addresses

Primary practice location

3000 Fairway Dr
Altoona, PA 16602-4472

Mailing address

101 Regent CT
State College, PA 16801-7965
Phone (814) 231-2101

Other practice location 1

100 Radnor Rd Ste 102
State College, PA 16801-7986
Phone (814) 231-2101

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250722002998 PA Practitioner - Physical Therapist in Private Practice 5193231538 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3000 Fairway Dr
Altoona, PA 16602-4472
Phone (814) 942-1166

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University Orthopedics Center, LTD Physical Therapist CurrentSince Jun 9, 2025 Accepting new patients
University Orthopedics Center, LTD CurrentSince Jun 9, 2025 Accepting new patients

Locations

3000 Fairway Dr
Altoona, PA 16602
Phone (814) 942-1166

100 Radnor Rd
Ste 102
State College, PA 16801
Phone (814) 231-2301

101 Regent Ct
State College, PA 16801
Phone (814) 231-1504

Interoperability endpoints

  • Direct secure messaging: mikayla.mignogna.p1@direct.uoc.nextgenshare.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1747699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1205628971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 REGENT CT",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168017965",
            "telephone_number": "814-231-2101",
            "fax_number": "814-231-8569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 FAIRWAY DR",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166024472",
            "telephone_number": "814-231-2101",
            "fax_number": "814-231-8569"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Radnor Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "State College",
            "state": "PA",
            "postal_code": "168017986",
            "country_code": "US",
            "telephone_number": "814-231-2101",
            "fax_number": "814-231-8569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIGNOGNA",
        "first_name": "MIKAYLA",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-20",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altoona, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2025; 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.