Individual provider Active NPI

Marguerite A Mullen, PT

  • Physical Therapist
  • Berwyn, PA
National Provider Identifier
1710686936
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT028045 Issued in PA
Practice address
511 Old Lancaster Rd Ste 12
Berwyn, PA 19312-1671
Phone
(484) 919-5601
NPI assigned
Feb 27, 2023
Last updated
Dec 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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 PT028045 PA Primary

Addresses

Primary practice location

511 Old Lancaster Rd Ste 12
Berwyn, PA 19312-1671

Mailing address

511 Old Lancaster Rd Ste 12
Berwyn, PA 19312-1671
Phone (484) 919-5601

Other names 1

  • Marguerite Stathes Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230410002417 PA Practitioner - Physical Therapist in Private Practice 9234504077 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
JMB Therapy Services LLCGroup PAC ID 8628243748, 28 clinicians

Practice addresses (Care Compare)

511 Old Lancaster Rd
Suite 12
Berwyn, PA 19312-1671
Phone (610) 225-2451

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT028045PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
JMB Therapy Services LLC Physical Therapist CurrentSince Dec 31, 2023 Accepting new patients
JMB Therapy Services LLC Physical Therapist CurrentSince Feb 28, 2023 Accepting new patients

Locations

511 Old Lancaster Rd
Ste 12
Berwyn, PA 19312
Phone (610) 225-2451

Organizations & group practices 2

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": "1677456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1710686936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 OLD LANCASTER RD STE 12",
            "city": "BERWYN",
            "state": "PA",
            "postal_code": "193121671",
            "telephone_number": "484-919-5601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 OLD LANCASTER RD STE 12",
            "city": "BERWYN",
            "state": "PA",
            "postal_code": "193121671",
            "telephone_number": "484-919-5601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "MARGUERITE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-27",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT028045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARGUERITE",
            "last_name": "STATHES",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Berwyn, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; 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.