Active NPI
Mitchell Kauk, PT OCS
- Orthopedic Physical Therapist
- Petaluma, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- PT10959
- Practice address
- 224A Weller St
Petaluma, CA 94952-3136 - Phone
- (707) 762-7678
- Fax
- (707) 762-7679
- NPI assigned
- Oct 26, 2006
- Last updated
- May 16, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | PT10959 | CA | Primary |
Addresses
Primary practice location
224A Weller St
Petaluma, CA 94952-3136
Mailing address
224A Weller St
Petaluma, CA 94952-3136
Phone (707) 762-7678
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 093769 | Other | CA | HEALTHNET PROVIDER ID |
| 677476 | Other | CA | ACN/BLUE SHIELD PROVIDER |
| PT0109590 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- University of California, San Francisco School of Medicine, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
224 A Weller St
Petaluma, CA 94952-3410
Phone (707) 762-7678
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.03 of 100
- Quality
- 85
- Improvement activities
- 40
- Cost
- 90.11
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT10959 | CA | MD | Orthopedic Physical Therapist |
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Chiropractor
- Stinson Beach, CA
- NPI 1174609192
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Petaluma Orthopaedic & Sports Therapy (P.O.S.T.)
- Orthopedic Physical Therapist
- Petaluma, CA
- NPI 1972667947
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1368662400000",
"number": "1548345390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "224A WELLER ST",
"city": "PETALUMA",
"state": "CA",
"postal_code": "949523136",
"telephone_number": "707-762-7678",
"fax_number": "707-762-7679"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "224A WELLER ST",
"city": "PETALUMA",
"state": "CA",
"postal_code": "949523136",
"telephone_number": "707-762-7678",
"fax_number": "707-762-7679"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAUK",
"first_name": "MITCHELL",
"credential": "PT OCS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-26",
"last_updated": "2013-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "CA",
"license": "PT10959",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET PROVIDER ID",
"identifier": "093769",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ACN/BLUE SHIELD PROVIDER",
"identifier": "677476",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PT0109590",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Petaluma, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2013; 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.