Individual provider Active NPI

Akanksha Mago, PT

  • Physical Therapist
  • Fresno, CA
National Provider Identifier
1649674201
Registry record updated Jan 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT41619 Issued in CA
Practice address
1700 E Bullard Ave
Suite# 102
Fresno, CA 93710-5866
Phone
(559) 438-8531
Fax
(559) 438-8307
NPI assigned
Oct 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2022

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 PT41619 CA Primary

Addresses

Primary practice location

1700 E Bullard Ave
Suite# 102
Fresno, CA 93710-5866

Mailing address

1700 E Bullard Ave
Suite# 102
Fresno, CA 93710-5866
Phone (559) 438-8531

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211018002096 CA Practitioner - Physical Therapist in Private Practice 2961770219 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT41619CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic and Neurological Rehabilitation, Speech Pathology, Inc CurrentSince Jun 23, 2021 Accepting new patients
Orthopaedic and Neurological Rehab Inc Physical Therapist CurrentSince Jun 23, 2021 Accepting new patients
McGuire Physical Therapy, Inc. Physical Therapist PastSince Dec 6, 2004 Accepting new patients

Locations

2950 Sierra Sunrise Ter
Chico, CA 95928
Phone (530) 941-1017

3900 Dale Rd
Modesto, CA 95356
Phone (209) 492-0128

8500 Bluffstone Cv
Ste A201
Austin, TX 78759
Phone (512) 220-5252

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": "1412899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1649674201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 E BULLARD AVE",
            "address_2": "SUITE# 102",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937105866",
            "telephone_number": "559-438-8531",
            "fax_number": "559-438-8307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E BULLARD AVE",
            "address_2": "SUITE# 102",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937105866",
            "telephone_number": "559-438-8531",
            "fax_number": "559-438-8307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGO",
        "first_name": "AKANKSHA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-10",
        "last_updated": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT41619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "7300 N Fresno St",
            "city": "Fresno",
            "state": "CA",
            "country_code": "US",
            "postal_code": "937202941",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.