Individual provider Active NPI

Julio Xavier Raagas Mallonga, PT, DPT

  • Physical Therapist
  • Amherst, MA
National Provider Identifier
1710399829
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
23911 Issued in MA
Practice address
31 Hall Dr
Amherst, MA 01002-2751
Phone
(413) 256-8561
Fax
(866) 644-0869
NPI assigned
May 22, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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 23911 MA Primary

Addresses

Primary practice location

31 Hall Dr
Amherst, MA 01002-2751

Mailing address

31 Hall Dr
Amherst, MA 01002-2751
Phone (413) 256-8561

Other practice location 1

329 Conway St
Greenfield, MA 01301-1521
Phone (413) 774-6301

Other practice location 2

238 Northampton St
Easthampton, MA 01027-1046
Phone (413) 529-9300

Other practice location 3

70 Main St
Florence, MA 01062-1466
Phone (413) 586-8400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190916001067 MA Practitioner - Physical Therapist in Private Practice 1951630029 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Medical Group PCGroup PAC ID 2365348851, 106 clinicians

Practice addresses (Care Compare)

31 Hall Dr
Amherst, MA 01002-2751
Phone (413) 256-4415

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Medical Group, P.C. CurrentSince Apr 18, 2022 Accepting new patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Sep 23, 2019 Accepting new patients
Valley Medical Group, P.C. Physical Therapist CurrentSince Apr 18, 2022 Accepting new patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Sep 23, 2019 Accepting new patients
Valley Medical Group, P.C. Past Accepting new patients

Locations

33377 Collection Ctr Dr
Chicago, IL 60693
Phone (617) 284-9418

31 Hall Dr
Amherst, MA 01002
Phone (413) 256-8561

101 University Dr
Ste A6
Amherst, MA 01002
Phone (413) 336-5703

238 Northampton St
Easthampton, MA 01027
Phone (413) 529-9300

329 Conway St
Greenfield, MA 01301
Phone (413) 774-6301

70 Main St
Northampton, MA 01062
Phone (413) 586-8400

84 Willimansett St
South Hadley, MA 01075
Phone (413) 533-8501

Interoperability endpoints

  • Direct secure messaging: julio.xavier.mallonga.1@55.direct.athenahealth.com

Organizations & group practices 5

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": "1400716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1710399829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 HALL DR",
            "city": "AMHERST",
            "state": "MA",
            "postal_code": "010022751",
            "telephone_number": "413-256-8561",
            "fax_number": "866-644-0869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 HALL DR",
            "city": "AMHERST",
            "state": "MA",
            "postal_code": "010022751",
            "telephone_number": "413-256-8561",
            "fax_number": "866-644-0869"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "329 Conway St",
            "address_purpose": "LOCATION",
            "city": "Greenfield",
            "state": "MA",
            "postal_code": "013011521",
            "country_code": "US",
            "telephone_number": "413-774-6301",
            "fax_number": "866-644-0871",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "238 Northampton St",
            "address_purpose": "LOCATION",
            "city": "Easthampton",
            "state": "MA",
            "postal_code": "010271046",
            "country_code": "US",
            "telephone_number": "413-529-9300",
            "fax_number": "866-644-0870",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "70 Main St",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "MA",
            "postal_code": "010621466",
            "country_code": "US",
            "telephone_number": "413-586-8400",
            "fax_number": "866-644-0872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALLONGA",
        "first_name": "JULIO XAVIER",
        "middle_name": "RAAGAS",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-22",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "23911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; 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.