Individual provider Active NPI

Mark Joseph McMahon, DPT

  • Physical Therapist
  • Belmont, CA
National Provider Identifier
1487799987
Registry record updated Jun 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
29917 Issued in CA
Practice address
549 Ralson Avenue
Suite B
Belmont, CA 94002
Phone
(650) 363-5668
Fax
(650) 363-5669
NPI assigned
Feb 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2009

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 29917 CA Primary

Addresses

Primary practice location

549 Ralson Avenue
Suite B
Belmont, CA 94002

Mailing address

540 Ralson Avenue
Suite B
Belmont, CA 94002
Phone (650) 363-5668

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29917CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Therx Past Accepting new patients
Lisa Green Physical Therapy, PC PastSince Apr 6, 2023 Accepting new patients
Pacific Therx, Inc. Past Accepting new patients

Organizations & group practices 3

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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245628800000",
    "number": "1487799987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 RALSON AVENUE",
            "address_2": "SUITE B",
            "city": "BELMONT",
            "state": "CA",
            "postal_code": "94002",
            "telephone_number": "650-363-5668",
            "fax_number": "650-363-5669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "549 RALSON AVENUE",
            "address_2": "SUITE B",
            "city": "BELMONT",
            "state": "CA",
            "postal_code": "94002",
            "telephone_number": "650-363-5668",
            "fax_number": "650-363-5669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMAHON",
        "first_name": "MARK",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2009-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "29917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belmont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.