Individual provider Active NPI

Michael J Mullaney, DPT

  • Physical Therapist
  • Matawan, NJ
National Provider Identifier
1255428603
Registry record updated Dec 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01157000 Issued in NJ
Practice address
127 Main St
Suite E
Matawan, NJ 07747-2621
Phone
(732) 970-4974
Fax
(732) 576-1542
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2011

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 40QA01157000 NJ Primary

Addresses

Primary practice location

127 Main St
Suite E
Matawan, NJ 07747-2621

Mailing address

PO Box 4071
Middletown, NJ 07748-4071
Phone (732) 576-1500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060217000049 NJ Practitioner - Physical Therapist in Private Practice 1052326766 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mullaney and Associates Physical TherapyGroup PAC ID 3072529437, 5 clinicians

Practice addresses (Care Compare)

127 Main St
Suite E
Matawan, NJ 07747-2621
Phone (732) 970-4974

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mullaney and Associates Physical Therapy Physical Therapist CurrentSince Jan 6, 2006 Accepting new patients

Locations

127 Main St
Matawan, NJ 07747
Phone (732) 970-4974

127 Main St
Ste E
Matawan, NJ 07747
Phone (732) 970-4974

Organizations & group practices 1

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": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325030400000",
    "number": "1255428603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4071",
            "city": "MIDDLETOWN",
            "state": "NJ",
            "postal_code": "077484071",
            "telephone_number": "732-576-1500",
            "fax_number": "732-576-1542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 MAIN ST",
            "address_2": "SUITE E",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077472621",
            "telephone_number": "732-970-4974",
            "fax_number": "732-576-1542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLANEY",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2011-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01157000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Matawan, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2011; 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.