Individual provider Active NPI

Jenna Kay Mahdi, DPT

  • Physical Therapist
  • Phoenix, AZ
National Provider Identifier
1669012175
Registry record updated Jan 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
LPT-31031 Issued in AZ
Practice address
3700 N 24TH St Ste 230
Phoenix, AZ 85016-6526
Phone
(480) 821-1997
Fax
(480) 821-2536
NPI assigned
Jan 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2020

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 LPT-31031 AZ Primary

Addresses

Primary practice location

3700 N 24TH St Ste 230
Phoenix, AZ 85016-6526

Mailing address

1076 W Chandler Blvd Ste 103
Chandler, AZ 85224-5223
Phone (480) 821-1997

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200329000737 AZ Practitioner - Physical Therapist in Private Practice 9931538881 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

3141 S McClintock Dr
Suite 2
Tempe, AZ 85282-5682
Phone (480) 566-8125

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPT-31031AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Jan 10, 2022 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Jan 10, 2022 Accepting new patients
Shelley McClellan PT PLLC Physical Therapist CurrentSince Sep 25, 2020 Accepting new patients
Camelback Sports Therapy LLC Physical Therapist CurrentSince Nov 2, 2020 Accepting new patients

Locations

6070 W Bell Rd
Ste A103
Glendale, AZ 85308
Phone (602) 782-3965

4800 N 44th St
Phoenix, AZ 85018
Phone (602) 808-8989

100 E Camelback Rd
Ste 120
Phoenix, AZ 85012
Phone (602) 808-8989

3141 S McClintock Dr
Ste 2
Tempe, AZ 85282
Phone (480) 566-8125

6970 N Oracle Rd
Ste 130
Tucson, AZ 85704
Phone (520) 219-5825

8270 S Houghton Rd
Ste 180
Tucson, AZ 85747
Phone (520) 664-1430

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

Interoperability endpoints

  • Direct secure messaging: jenna.mahdi.p6@direct.athleticoltd.nextgenshare.com

Organizations & group practices 4

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": "1578873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578873600000",
    "number": "1669012175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1076 W CHANDLER BLVD STE 103",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852245223",
            "telephone_number": "480-821-1997",
            "fax_number": "480-821-2536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 N 24TH ST STE 230",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850166526",
            "telephone_number": "480-821-1997",
            "fax_number": "480-821-2536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHDI",
        "first_name": "JENNA",
        "middle_name": "KAY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-13",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-31031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2020; 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.