Individual provider Active NPI

Mary Charlene Docdocil Gayas, PT

  • Physical Therapist
  • Houston, TX
National Provider Identifier
1679702559
Registry record updated Feb 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1332901 Issued in TX
Practice address
11110 Bellaire Blvd Ste 240
Houston, TX 77072-2600
Phone
(888) 880-9525
Fax
(888) 880-9525
NPI assigned
Jul 13, 2009
Reactivated
Jul 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2022

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 031121-1 NY
Physical Therapist 225100000X 1332901 TX Primary

Addresses

Primary practice location

11110 Bellaire Blvd Ste 240
Houston, TX 77072-2600

Mailing address

9140 Highway 6 N Apt 102
Houston, TX 77095-2479
Phone (346) 448-5167

Other names 1

  • Mary Charlene Docdocil Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220708001060 TX Practitioner - Physical Therapist in Private Practice 0941456024 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Access Rehab and Wellness CenterGroup PAC ID 8527459858, 4 clinicians

Practice addresses (Care Compare)

11110 Bellaire Blvd
Houston, TX 77072-2600
Phone (949) 669-1836

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
031121-1NYMDPhysical Therapist
031121NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Access Rehab and Wellness Center Physical Therapist CurrentSince Jun 1, 2022 Accepting new patients

Locations

11110 Bellaire Blvd
Ste 240
Houston, TX 77072
Phone (888) 880-9525

11110 Bellaire Blvd
Ofc
Houston, TX 77072
Phone (949) 669-1836

11110 Bellaire Blvd
Houston, TX 77072
Phone (949) 669-1836

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1247443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645228800000",
    "number": "1679702559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9140 HIGHWAY 6 N APT 102",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770952479",
            "telephone_number": "346-448-5167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11110 BELLAIRE BLVD STE 240",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770722600",
            "telephone_number": "888-880-9525",
            "fax_number": "888-880-9525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAYAS",
        "first_name": "MARY CHARLENE",
        "middle_name": "DOCDOCIL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-13",
        "last_updated": "2022-02-19",
        "certification_date": "2022-02-19",
        "deactivation_date": "2011-11-22",
        "reactivation_date": "2012-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "031121-1",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1332901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY CHARLENE",
            "last_name": "DOCDOCIL",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2022; 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.