Individual provider Active NPI

Mary Therese Deason, PT

  • Physical Therapist
  • Spring Valley, CA
National Provider Identifier
1336217603
Registry record updated May 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT15698 Issued in CA
Practice address
10225 Austin Dr
Suite 106
Spring Valley, CA 91978-1500
Phone
(619) 660-8895
Fax
(619) 660-8697
NPI assigned
Dec 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2018

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 PT15698 CA Primary

Addresses

Primary practice location

10225 Austin Dr
Suite 106
Spring Valley, CA 91978-1500

Mailing address

10225 Austin Dr
Ste 106
Spring Valley, CA 91978-1521
Phone (619) 938-0201

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041123001253 CA Practitioner - Physical Therapist in Private Practice 0749242162 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deason IncGroup PAC ID 6305808718, 3 clinicians

Practice addresses (Care Compare)

10225 Austin Dr
Spring Valley, CA 91978-1500

10225 Austin Dr
Suite 106
Spring Valley, CA 91978-1521
Phone (619) 660-8895

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT15698CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Deason Inc Physical Therapist CurrentSince May 28, 2002 Accepting new patients

Locations

6845 University Ave
San Diego, CA 92115
Phone (619) 660-8895

10225 Austin Dr
Ste 106
Spring Valley, CA 91978
Phone (619) 660-8895

Organizations & group practices 1

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": "1165017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525305600000",
    "number": "1336217603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10225 AUSTIN DR",
            "address_2": "STE 106",
            "city": "SPRING VALLEY",
            "state": "CA",
            "postal_code": "919781521",
            "telephone_number": "619-938-0201",
            "fax_number": "619-938-0201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10225 AUSTIN DR",
            "address_2": "SUITE 106",
            "city": "SPRING VALLEY",
            "state": "CA",
            "postal_code": "919781500",
            "telephone_number": "619-660-8895",
            "fax_number": "619-660-8697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEASON",
        "first_name": "MARY",
        "middle_name": "THERESE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-02",
        "last_updated": "2018-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT15698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2018; 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.