Individual provider Active NPI

Mary Ellen Jankovsky, PT

  • Physical Therapist
  • Cincinnati, OH
National Provider Identifier
1396944849
Registry record updated Aug 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
011783 Issued in OH
Practice address
5754 Bridgetown Rd
Suite 2
Cincinnati, OH 45248
Phone
(513) 661-6555
NPI assigned
Jul 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2022

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 005112 KY
Physical Therapist 225100000X 011783 OH Primary

Addresses

Primary practice location

5754 Bridgetown Rd
Suite 2
Cincinnati, OH 45248

Mailing address

5754 Bridgetown Rd
Suite 2
Cincinnati, OH 45248
Phone (513) 661-6555

Other names 1

  • Mrs. Mary Ellen Larimer Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220916002660 OH Practitioner - Physical Therapist in Private Practice 3173908720 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blake and Associates IncGroup PAC ID 9638076276, 7 clinicians

Practice addresses (Care Compare)

5754 Bridgetown Rd
Cincinnati, OH 45248-3100
Phone (513) 661-6555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005112KYMDPhysical Therapist
011783OHMDPhysical Therapist

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": "1184457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661472000000",
    "number": "1396944849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5754 BRIDGETOWN RD",
            "address_2": "SUITE 2",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45248",
            "telephone_number": "513-661-6555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5754 BRIDGETOWN RD",
            "address_2": "SUITE 2",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45248",
            "telephone_number": "513-661-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANKOVSKY",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-15",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "005112",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "011783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "LARIMER",
            "middle_name": "ELLEN",
            "prefix": "MRS.",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.