Mitchell V Prunk, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

63232 Issued in OR

Practice address

400 Hickory St NW Ste 201
Albany, OR 97321-1700

Phone

(541) 812-5840

NPI assigned

Jun 13, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Albany General HospitalGroup PAC ID 9931097987, 191 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

94.37 of 100Reported as group

Quality

92.31

Promoting interoperability

100

Improvement activities

40

Cost

80.9

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Albany General Hospital

  dba Samaritan Albany General Hospital

  • General Acute Care Hospital
  • Albany, OR
  • NPI 1154372340
  Medicare reassignment Care Compare group NPD
• Albany General Hospital

  dba Samaritan Heart & Rhythm Center of Albany

  • Internal Medicine Physician
  • Albany, OR
  • NPI 1104182369
  NPD
• Albany General Hospital

  dba Samaritan InterCommunity Health Clinic - Albany

  • Family Medicine Physician
  • Albany, OR
  • NPI 1306679816
  NPD

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

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1215596101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HICKORY ST NW STE 201",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973211700",
            "telephone_number": "541-812-5840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1046 6th Ave SW",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "OR",
            "postal_code": "973211916",
            "country_code": "US",
            "telephone_number": "541-812-4160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRUNK",
        "first_name": "MITCHELL",
        "middle_name": "V",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-13",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "63232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mprunk166775@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "400 Hickory St NW Ste 201",
            "city": "Albany",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973211700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Philip A. Prewette, M.A.
• Travis Holden Prichard
• Kayla Cherie Priddy
• Alixandre K Pruett, L.M.T.
• Vickie Lee Pruitt, LMT 5614
• Juana Carina Puentes
• Debra A Puerner, NP
• Ayushi Clare Purell
• Qualicenters Albany, LTD. (Fresenius Medical Care Albany - Oregon)
• Elena Marina Rabago

• Physical Therapist in Albany, OR
• Providers in Albany, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; 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.