Individual provider Active NPI

Jonathan Robert Pauly, M.P.T

  • Physical Therapist
  • Chandler, AZ
National Provider Identifier
1407952435
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5440 Issued in AZ
Practice address
1370 W Saragosa PL
Chandler, AZ 85224-7216
Phone
(480) 250-4741
Fax
(480) 840-1404
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical Therapist 2251G0304X 5440 AZ
Human Factors Physical Therapist 2251H1300X 5440 AZ
Neurology Physical Therapist 2251N0400X 5440 AZ
Orthopedic Physical Therapist 2251X0800X 5440 AZ
Physical Therapist 225100000X 5440 AZ Primary

Addresses

Primary practice location

1370 W Saragosa PL
Chandler, AZ 85224-7216

Mailing address

PO Box 6854
Chandler, AZ 85246-6854
Phone (480) 250-4741

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031111000834 AZ Practitioner - Physical Therapist in Private Practice 8729991054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1370 W Saragosa PL
Chandler, AZ 85224-7216
Phone (480) 250-4741

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5440AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
House Call Physical Therapy Physical Therapist CurrentSince Feb 1, 2006 Accepting new patients
Saguaro Health Care Physical Therapist Past Accepting new patients

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1407952435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6854",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852466854",
            "telephone_number": "480-250-4741",
            "fax_number": "480-840-1404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 W SARAGOSA PL",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852247216",
            "telephone_number": "480-250-4741",
            "fax_number": "480-840-1404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULY",
        "first_name": "JONATHAN",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "M.P.T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "AZ",
            "license": "5440",
            "primary": false
        },
        {
            "code": "2251H1300X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Human Factors",
            "state": "AZ",
            "license": "5440",
            "primary": false
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "AZ",
            "license": "5440",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "AZ",
            "license": "5440",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "5440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2021; 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.