Individual provider Active NPI

Craig R. Mason, PT, DPT, ATC

  • Physical Therapist
  • Midlothian, VA
National Provider Identifier
1689127508
Registry record updated Apr 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305210405 Issued in VA
Practice address
15757 WC Main St
Midlothian, VA 23113-7327
Phone
(804) 858-0220
Fax
(804) 419-0127
NPI assigned
Jul 27, 2016
Last updated
Apr 25, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2018

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 2305210405 VA Primary

Addresses

Primary practice location

15757 WC Main St
Midlothian, VA 23113-7327

Mailing address

PO Box 69030
Baltimore, MD 21264-9030
Phone (757) 873-2302

Other identifiers 2

IdentifierTypeStateIssuer
C05954OtherVAGROUP MEDICARE PTAN
1689127508OtherVAMEDICAID QMB PROVIDER ID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160922001160 VA Practitioner - Physical Therapist in Private Practice 0840587671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tidewater Physical Therapy LLCGroup PAC ID 6406759281, 225 clinicians

Practice addresses (Care Compare)

15757 WC Main St
Midlothian, VA 23113-7327
Phone (804) 858-0220

Merit-based Incentive Payment System (MIPS)

Final score
88.16 of 100Reported as group
Quality
85.78
Promoting interoperability
99
Improvement activities
40
Cost
75.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305210405VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Aug 8, 2016 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Aug 8, 2016 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist Past Accepting new patients
Tidewater Physical Therapy LLC Physical Therapist Past Accepting new patients
Tidewater Physical Therapy LLC Physical Therapist Past Accepting new patients
Tidewater Physical Therapy LLC Physical Therapist Past Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist Past Accepting new patients

Locations

10128 W Broad St
Bldg Iii
Glen Allen, VA 23060
Phone (804) 217-9210

15757 Wc Main St
Midlothian, VA 23113
Phone (804) 858-0220

771 Pilot House Dr
#A
Newport News, VA 23606
Phone (757) 873-2302

Organizations & group practices 7

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": "1469577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524614400000",
    "number": "1689127508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 69030",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212649030",
            "telephone_number": "757-873-2302",
            "fax_number": "757-873-2306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15757 WC MAIN ST",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231137327",
            "telephone_number": "804-858-0220",
            "fax_number": "804-419-0127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "CRAIG",
        "middle_name": "R.",
        "credential": "PT, DPT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-27",
        "last_updated": "2018-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305210405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE PTAN",
            "identifier": "C05954",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID QMB PROVIDER ID",
            "identifier": "1689127508",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2018; 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.