Active NPI
Michael McMahon, PT
- Physical Therapist
- Roseville, CA
National Provider Identifier
1699051771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT9571
- Practice address
- 114 N Sunrise Ave
Suite B-1
Roseville, CA 95661-2916 - Phone
- (916) 789-1384
- Fax
- (916) 782-7113
- NPI assigned
- Nov 2, 2011
- Sex
- Male
- 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 | PT9571 | CA | Primary |
Addresses
Primary practice location
114 N Sunrise Ave
Suite B-1
Roseville, CA 95661-2916
Mailing address
114 N Sunrise Ave
Suite B-1
Roseville, CA 95661-2916
Phone (916) 789-1384
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT9571 | CA | MD | Physical Therapist |
| 9571 | CA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehabilitation & Occupational Consultants | Physical Therapist | Past | Accepting new patients |
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.
-
- Physical Therapist
- Folsom, CA
- NPI 1164422614
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320192000000",
"number": "1699051771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "114 N SUNRISE AVE",
"address_2": "SUITE B-1",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956612916",
"telephone_number": "916-789-1384",
"fax_number": "916-782-7113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 N SUNRISE AVE",
"address_2": "SUITE B-1",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956612916",
"telephone_number": "916-789-1384",
"fax_number": "916-782-7113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCMAHON",
"first_name": "MICHAEL",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-11-02",
"last_updated": "2011-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT9571",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roseville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.