Individual provider Active NPI

Shaugn Mallari

  • Physical Therapist
  • Austin, TX
National Provider Identifier
1295203339
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
298016 Issued in CA
Practice address
1212 W Parmer LN Ste E
Austin, TX 78727-4657
Phone
(512) 670-3238
NPI assigned
Nov 7, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 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 298016 CA Primary

Addresses

Primary practice location

1212 W Parmer LN Ste E
Austin, TX 78727-4657

Mailing address

1475 Island Ave
Unit 2403
San Diego, CA 92101-8244
Phone (818) 438-5991

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200429002463 CA Practitioner - Physical Therapist in Private Practice 9133464043 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3959 Ruffin Rd
Suite J
San Diego, CA 92123-1830
Phone (858) 279-5570

Merit-based Incentive Payment System (MIPS)

Final score
74.62 of 100Reported as group
Quality
70
Improvement activities
40
Cost
70.4

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
298016CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab United Sports Medicine & Physical Therapy, Inc. Physical Therapist CurrentSince Nov 18, 2024 Accepting new patients
Positive Physical Therapy and Fitness Inc CurrentSince Mar 1, 2020 Accepting new patients
South Pacific Physical Therapy Inc Physical Therapist CurrentSince Nov 17, 2022 Accepting new patients
Rehab United Sports Medicine & Physical Therapy, Inc. CurrentSince Nov 18, 2024 Accepting new patients

Locations

5850 El Camino Real
Ste 111
Carlsbad, CA 92008
Phone (760) 542-2414

4924 Balboa Blvd
Encino, CA 91316
Phone (805) 479-8706

12207 Santa Monica Blvd
Los Angeles, CA 90025
Phone (310) 770-7586

3959 Ruffin Rd
Ste J
San Diego, CA 92123
Phone (858) 279-5570

4940 Van Nuys Blvd
Ste 301
Van Nuys, CA 91403
Phone (818) 907-0952

Organizations & group practices 4

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": "1541548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1295203339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 ISLAND AVE",
            "address_2": "UNIT 2403",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921018244",
            "telephone_number": "818-438-5991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 W PARMER LN STE E",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787274657",
            "telephone_number": "512-670-3238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLARI",
        "first_name": "SHAUGN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-07",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "298016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.