Individual provider Active NPI

Bonnie Yesian Muehlendorf

  • Physical Therapist
  • Georgetown, TX
National Provider Identifier
1609025048
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1153368 Issued in TX
Practice address
3415 Williams Dr Ste 145
Georgetown, TX 78628-2886
Phone
(512) 887-4544
NPI assigned
Sep 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTH8592 AL
Physical Therapist 225100000X 1153368 TX Primary

Addresses

Primary practice location

3415 Williams Dr Ste 145
Georgetown, TX 78628-2886

Mailing address

PO Box 932184
Atlanta, GA 31193-2184

Other names 1

  • Bonnie Patricia Yesian Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, GA, SC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20090126000516 TX Practitioner - Physical Therapist in Private Practice 8224192885 Reassigns benefits to 1 organization
I20201102001330 GA Practitioner - Physical Therapist in Private Practice 8224192885 Reassigns benefits to 2 organizations
I20210224002811 SC Practitioner - Physical Therapist in Private Practice 8224192885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Rehab Center IncGroup PAC ID 6800989369, 123 clinicians

Practice addresses (Care Compare)

3415 Williams Dr
Suite 145 Georgetown Physical Therapy
Georgetown, TX 78628-2886
Phone (512) 887-4544

6911 Ranch Rd 620
B 201
Austin, TX 78732-1920
Phone (512) 467-4546

896 Summit St
Suite 102
Round Rock, TX 78664-4370
Phone (512) 599-4262

Merit-based Incentive Payment System (MIPS)

Final score
74.64 of 100Reported as group
Quality
46.1
Promoting interoperability
92
Improvement activities
40
Cost
76.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10509SCMDGeneral Practice Dentistry
1153368TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ledesma Sports Medicine LLC Physical Therapist CurrentSince Dec 1, 2021 Accepting new patients
Optim Orthopedics, LLC CurrentSince Dec 11, 2020 Accepting new patients
Optim Orthopedics, LLC CurrentSince Feb 1, 2021 Accepting new patients
Optim Orthopedics, LLC CurrentSince Dec 11, 2020 Accepting new patients
Optim Orthopedics, LLC PastSince Oct 6, 2019 Accepting new patients

Locations

247 S Main St
#A
Reidsville, GA 30453
Phone (912) 352-4490

7010 Hodgson Memorial Dr
Savannah, GA 31406
Phone (912) 401-0443

210 E Derenne Ave
Savannah, GA 31405
Phone (912) 355-0140

8201 Pinellas Dr
Bluffton, SC 29910
Phone (843) 705-9401

Organizations & group practices 6

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": "1221004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1609025048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932184",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311932184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 WILLIAMS DR STE 145",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786282886",
            "telephone_number": "512-887-4544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUEHLENDORF",
        "first_name": "BONNIE",
        "middle_name": "YESIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-10",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH8592",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1153368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BONNIE",
            "last_name": "YESIAN",
            "middle_name": "PATRICIA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Georgetown, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.