Individual provider Active NPI

Mary Kathryn O'Callaghan, PT

  • Physical Therapist
  • Blauvelt, NY
National Provider Identifier
1265740922
Registry record updated Sep 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
021054-1 Issued in NY
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

Updated by the provider on Sep 15, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
40QA00719500NJMDPhysical Therapist
021054-1NYMDPhysical 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.

Verify at the official NPI Registry.