Individual provider Active NPI

Mikayla Jones, DPT

  • Physical Therapist
  • Mill Valley, CA
National Provider Identifier
1255052452
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
302602 Issued in CA
Practice address
23 Reed Blvd Ste 100
Mill Valley, CA 94941-2370
Phone
(415) 888-2289
NPI assigned
Sep 6, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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 302602 CA Primary

Addresses

Primary practice location

23 Reed Blvd Ste 100
Mill Valley, CA 94941-2370

Mailing address

1162B Gorgas Ave
San Francisco, CA 94129-1406
Phone (415) 561-6655

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221101002972 CA Practitioner - Physical Therapist in Private Practice 0244607406 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presidio Sport and Medicine, Inc.Group PAC ID 2466447651, 18 clinicians

Practice addresses (Care Compare)

23 Reed Blvd
Suite 100
Mill Valley, CA 94941-2370
Phone (415) 888-2289

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
302602CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Presidio Sport & Medicine, Inc. Physical Therapist CurrentSince Sep 1, 2022 Accepting new patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Feb 27, 2026 Accepting new patients

Locations

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108

23 Reed Blvd
Ste 100
Mill Valley, CA 94941
Phone (415) 888-2289

1162B Gorgas Ave
San Francisco, CA 94129
Phone (415) 561-6655

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1662422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1255052452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1162B GORGAS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941291406",
            "telephone_number": "415-561-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 REED BLVD STE 100",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949412370",
            "telephone_number": "415-888-2289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "MIKAYLA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-06",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "302602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; 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.