Jennifer J Mastro

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

192A Issued in MN

Practice address

4415 W 36 1/2 St
St Louis Park, MN 55416-4854

Phone

(952) 927-9717

Fax

(925) 927-7687

NPI assigned

Oct 25, 2011

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1319500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319500800000",
    "number": "1629354477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4415 W 36 1/2 ST",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164854",
            "telephone_number": "952-927-9717",
            "fax_number": "925-927-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4415 W 36 1/2 ST",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164854",
            "telephone_number": "952-927-9717",
            "fax_number": "925-927-7687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTRO",
        "first_name": "JENNIFER",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-25",
        "last_updated": "2011-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MN",
            "license": "192A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mason Moore Consultants
• Deborah Mason-Moore, M.S.
• Lura L Mason, DPT
• Christina Ann Massari, PSY.D.
• Jordyn Louise Massop, PA-C
• Ann Matko, LMFT
• Britta L Mattison
• Bethany Jean Mattson, MSW, LICSW
• Jordan Mauk, L.AC
• Gabrielle Mauren, PH.D.

• Physical Therapy Assistant in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Physical Therapy Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2011; 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.