Individual provider Active NPI

Lynne D. Maffeo, PT

  • Physical Therapist
  • Round Rock, TX
National Provider Identifier
1417192105
Registry record updated Jun 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1142636 Issued in TX
Practice address
555D Round Rock West Dr
160
Round Rock, TX 78681
Phone
(512) 244-6623
Fax
(512) 244-7758
NPI assigned
Dec 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2010

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 1142636 TX Primary

Addresses

Primary practice location

555D Round Rock West Dr
160
Round Rock, TX 78681

Mailing address

555D Round Rock West Dr
160
Round Rock, TX 78681
Phone (512) 244-6623

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230130001428 AZ Practitioner - Physical Therapist in Private Practice 0941474514 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Solace Pediatric Healthcare Therapy Services Az, Inc. Physical Therapist CurrentSince Oct 18, 2022 Accepting new patients
Inspire Therapy 4 Kidz LLC Current Accepting new patients
Barr Physical Therapy, P.C. Physical Therapist Past Accepting new patients
Pioneer Pet, LLC Past Accepting new patients

Locations

1930 E Southern Ave
Tempe, AZ 85282
Phone (480) 456-0719

60 E Rio Salado Pkwy
Ste 900
Tempe, AZ 85281
Phone (480) 456-0719

Organizations & group practices 4

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": "1228780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276214400000",
    "number": "1417192105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555D ROUND ROCK WEST DR",
            "address_2": "160",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "78681",
            "telephone_number": "512-244-6623",
            "fax_number": "512-244-7758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555D ROUND ROCK WEST DR",
            "address_2": "160",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "78681",
            "telephone_number": "512-244-6623",
            "fax_number": "512-244-7758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAFFEO",
        "first_name": "LYNNE",
        "middle_name": "D.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-09",
        "last_updated": "2010-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1142636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2010; 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.