Active NPI
Akanksha Mago, PT
- Physical Therapist
- Fresno, CA
National Provider Identifier
1649674201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT41619
- 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
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 |
|---|---|---|---|---|
| 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT41619 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopaedic and Neurological Rehabilitation, Speech Pathology, Inc | Current | Accepting new patients | |
| Orthopaedic and Neurological Rehab Inc | Physical Therapist | Current | Accepting new patients |
| McGuire Physical Therapy, Inc. | Physical Therapist | Past | Accepting new patients |
Locations
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Phone (530) 941-1017
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Phone (209) 492-0128
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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.
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CA, Physical Therapist
-
- Rehabilitation Clinic/Center
- Tustin, CA
- NPI 1548940885
-
- Sports Physical Therapist
- Fresno, CA
- NPI 1699860353
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.