Mitchell Scott Mahoney, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

63616 Issued in OR

Practice address

3871 Fairview Industrial Dr SE Ste 120
Salem, OR 97302-1172

Phone

(503) 990-6393

Fax

(503) 212-0414

NPI assigned

May 13, 2021

Last updated

Jul 31, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sportscare Physical Therapy @ Cornell, LLCGroup PAC ID 7517115579, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sportscare Physical Therapy @ Cornell, LLC

  • Physical Therapy Clinic/Center
  • Beaverton, OR
  • NPI 1649534793
  Medicare reassignment Care Compare group NPD
• Cascade 205 Orthopedic and Sports Physical Therapy, PC

  • Preferred Provider Organization
  • Portland, OR
  • NPI 1356348106
  Medicare reassignment NPD
• Sportscare Physical Therapy @ Cornell, LLC

  • Durable Medical Equipment & Medical Supplies
  • Tigard, OR
  • NPI 1255190153
  NPD
• Cascade Gresham Physical Therapy, Inc.

  • Specialist
  • Gresham, OR
  • NPI 1689657769
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1620864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1457925620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9260 SE STARK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972161675",
            "telephone_number": "503-255-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3871 FAIRVIEW INDUSTRIAL DR SE STE 120",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973021172",
            "telephone_number": "503-990-6393",
            "fax_number": "503-212-0414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9260 SE Stark St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972161675",
            "country_code": "US",
            "telephone_number": "503-255-1500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHONEY",
        "first_name": "MITCHELL",
        "middle_name": "SCOTT",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-13",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "63616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sky Deann Magwood, MD
• Kimo Mahi, ATC
• Meran Mahir, MD
• Lucy Mahler
• Erin Dakota Mahlum
• Timothy Michael Mahoney, M.D.
• Jordain Mahr, OTD, MHA
• Anne Maina
• Ella Mainwaring
• Tushar J Makadia, MD

• Physical Therapist in Salem, OR
• Providers in Salem, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; 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.