Active NPI
Mary Kathryn O'Callaghan, PT
- Physical Therapist
- Blauvelt, NY
National Provider Identifier
1265740922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 021054-1
- Practice address
- 160 Van Wyck Rd
Blauvelt, NY 10913-1229 - Phone
- (845) 680-1377
- NPI assigned
- Sep 15, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 021054-1 | NY | Primary |
| Physical Therapist | 225100000X | 40QA00719500 | NJ |
Addresses
Primary practice location
160 Van Wyck Rd
Blauvelt, NY 10913-1229
Mailing address
39 Violet Dr
Pearl River, NY 10965-1209
Phone (845) 215-9260
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA00719500 | NJ | MD | Physical Therapist |
| 021054-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284508800000",
"number": "1265740922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39 VIOLET DR",
"city": "PEARL RIVER",
"state": "NY",
"postal_code": "109651209",
"telephone_number": "845-215-9260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "160 VAN WYCK RD",
"city": "BLAUVELT",
"state": "NY",
"postal_code": "109131229",
"telephone_number": "845-680-1377"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'CALLAGHAN",
"first_name": "MARY",
"middle_name": "KATHRYN",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-15",
"last_updated": "2010-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "021054-1",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA00719500",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Blauvelt, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.