Individual provider Active NPI

Mutya C. O'Boyle, P.T.

  • Physical Therapist
  • Las Vegas, NV
National Provider Identifier
1740411263
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 2345 Issued in NV
Practice address
4800 E Bonanza Rd
Suite 2
Las Vegas, NV 89110-3470
Phone
(702) 438-3188
Fax
(702) 438-4550
NPI assigned
Jul 31, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 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 PT 2345 NV Primary

Addresses

Primary practice location

4800 E Bonanza Rd
Suite 2
Las Vegas, NV 89110-3470

Mailing address

3831 W Charleston Blvd
Las Vegas, NV 89102-1859
Phone (702) 876-1733

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091007000592 NV Practitioner - Physical Therapist in Private Practice 8123164068 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chynoweth Hill and Leavitt LLCGroup PAC ID 7012980550, 41 clinicians

Practice addresses (Care Compare)

305 N Nellis Blvd
Suite 135
Las Vegas, NV 89110-5497
Phone (702) 138-3188

3831 W Charleston Blvd
Las Vegas, NV 89102-1859
Phone (702) 876-1733

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 2345NVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Chynoweth Hill and Leavitt LLC CurrentSince Jul 27, 2009 Accepting new patients
Chynoweth Hill and Leavitt LLC Physical Therapist CurrentSince Jul 27, 2009 Accepting new patients
Chynoweth Hill and Leavitt LLC Physical Therapist Past Accepting new patients

Locations

3831 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 876-1733

305 N Nellis Blvd
Ste 135
Las Vegas, NV 89110
Phone (702) 438-3188

4800 E Bonanza Rd
Ste 2
Las Vegas, NV 89110
Phone (702) 438-3188

Organizations & group practices 3

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": "1248998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1740411263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3831 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021859",
            "telephone_number": "702-876-1733",
            "fax_number": "702-878-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 E BONANZA RD",
            "address_2": "SUITE 2",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891103470",
            "telephone_number": "702-438-3188",
            "fax_number": "702-438-4550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BOYLE",
        "first_name": "MUTYA",
        "middle_name": "C.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-31",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "PT 2345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

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