Individual provider Active NPI

Angela Mackay, PT, DPT

  • Physical Therapist
  • Erie, PA
National Provider Identifier
1295306892
Registry record updated Jul 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT029575 Issued in PA
Practice address
1645 W 8TH St
Erie, PA 16505-5097
Phone
(814) 875-8700
NPI assigned
Jul 5, 2021
Last updated
Jul 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2021

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 PTL.0017760 CO
Physical Therapist 225100000X PT029575 PA Primary

Addresses

Primary practice location

1645 W 8TH St
Erie, PA 16505-5097

Mailing address

9265 Abbey Rd
North Royalton, OH 44133-1127
Phone (440) 773-4843

Other practice location 1

1717 E 38th St
Erie, PA 16510-3411
Phone (814) 899-1023

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220407002726 CO Practitioner - Physical Therapist in Private Practice 1254727878 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTL.0017760COMDPhysical Therapist
PT029575PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Denver, LLC Current Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Apr 24, 2024 Accepting new patients
Denver Physical Therapy, P.C. Physical Therapist CurrentSince Dec 1, 2021 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Apr 24, 2024 Accepting new patients
Colorado Luna Care Physical Therapy LLC Physical Therapist CurrentSince Apr 24, 2024 Accepting new patients
Denver Physical Therapy, P.C. Physical Therapist CurrentSince Dec 1, 2021 Accepting new patients

Locations

500 Eldorado Blvd
Bldg 4
Broomfield, CO 80021
Phone (303) 812-4790

6840 S University Blvd
Ste 400
Centennial, CO 80122
Phone (303) 771-5120

501 S Cherry St
Fl 11
Denver, CO 80246
Phone (309) 530-8782

5801 S Quebec St
Ste 100
Greenwood Village, CO 80111
Phone (303) 694-9193

8550 W 38th Ave
Ste 100
Wheat Ridge, CO 80033
Phone (303) 467-4100

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1625443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625443200000",
    "number": "1295306892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9265 ABBEY RD",
            "city": "NORTH ROYALTON",
            "state": "OH",
            "postal_code": "441331127",
            "telephone_number": "440-773-4843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 W 8TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165055097",
            "telephone_number": "814-875-8700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1717 E 38th St",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165103411",
            "country_code": "US",
            "telephone_number": "814-899-1023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACKAY",
        "first_name": "ANGELA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-05",
        "last_updated": "2021-07-05",
        "certification_date": "2021-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0017760",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT029575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.