Individual provider Active NPI

Eric Patrick Mogck, MPT

  • Physical Therapist
  • Avondale, PA
National Provider Identifier
1316932999
Registry record updated Aug 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT015895 Issued in PA
Practice address
82 Pennsylvania Ave
Avondale, PA 19311-1140
Phone
(610) 268-5333
Fax
(610) 268-5331
NPI assigned
Sep 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2015

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 PT015895 PA Primary

Addresses

Primary practice location

82 Pennsylvania Ave
Avondale, PA 19311-1140

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other identifiers 2

IdentifierTypeStateIssuer
P01480137OtherPARR MEDICARE
M01424171OtherPABCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120402000219 PA Practitioner - Physical Therapist in Private Practice 1951561794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ati Holdings, LLCGroup PAC ID 9537112719, 440 clinicians

Practice addresses (Care Compare)

3483 E Lincoln Hwy
Unit 2
Thornsdale, PA 19372-1014
Phone (484) 784-4158

Merit-based Incentive Payment System (MIPS)

Final score
86.05 of 100Reported as group
Quality
89.12
Improvement activities
40
Cost
73.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings, LLC Physical Therapist CurrentSince Feb 27, 2012 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Feb 27, 2012 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

5038 Pennell Rd
Aston, PA 19014
Phone (610) 833-4600

82 Pennsylvania Ave
Avondale, PA 19311
Phone (610) 268-5333

266 Eagleview Blvd
Exton, PA 19341
Phone (610) 524-1019

160 Morton Ave
Folsom, PA 19033
Phone (414) 496-2683

826 E Baltimore Pike
Unit 9
Kennett Square, PA 19348
Phone (610) 335-1410

519 E Baltimore Pike
Media, PA 19063
Phone (484) 441-0622

416 Commons Dr
Parkesburg, PA 19365
Phone (610) 857-6099

9475 Roosevelt Blvd
Philadelphia, PA 19114
Phone (215) 464-6200

118 Townsedge Dr
Quarryville, PA 17566
Phone (717) 806-5126

779 W Sproul Rd
Springfield, PA 19064
Phone (484) 470-2150

4304 5th Street Hwy
Unit 4
Temple, PA 19560
Phone (484) 220-2912

3483 Lincoln Hwy
Unit 2
Thorndale, PA 19372
Phone (484) 784-4158

815 Lansdowne Ave
Unit 1006
Upper Darby, PA 19082
Phone (484) 452-2591

Organizations & group practices 2

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": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439510400000",
    "number": "1316932999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 PENNSYLVANIA AVE",
            "city": "AVONDALE",
            "state": "PA",
            "postal_code": "193111140",
            "telephone_number": "610-268-5333",
            "fax_number": "610-268-5331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGCK",
        "first_name": "ERIC",
        "middle_name": "PATRICK",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2015-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT015895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01480137",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "M01424171",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Avondale, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2015; 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.