Individual provider Active NPI

Mary Helen Panushka, D.P.T.

  • Physical Therapist
  • Hemet, CA
National Provider Identifier
1689033953
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
291139 Issued in CA
Practice address
3989 W Stetson Ave
Suite 105
Hemet, CA 92545-9695
Phone
(951) 652-3334
Fax
(951) 652-3335
NPI assigned
Feb 16, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 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 291139 CA Primary

Addresses

Primary practice location

3989 W Stetson Ave
Suite 105
Hemet, CA 92545-9695

Mailing address

25100 Vista Murrieta Apt 3436
Murrieta, CA 92562-2935
Phone (805) 205-3110

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160511000820 CA Practitioner - Physical Therapist in Private Practice 3476842667 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pow Physical Therapy a Professional CorporationGroup PAC ID 1658634043, 6 clinicians

Practice addresses (Care Compare)

1889 Knoll Dr
Ventura, CA 93003-7348
Phone (805) 644-1591

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
291139CAMDPhysical Therapist

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1455580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1689033953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25100 VISTA MURRIETA APT 3436",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925622935",
            "telephone_number": "805-205-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3989 W STETSON AVE",
            "address_2": "SUITE 105",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925459695",
            "telephone_number": "951-652-3334",
            "fax_number": "951-652-3335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANUSHKA",
        "first_name": "MARY",
        "middle_name": "HELEN",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "291139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hemet, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.