Kyle Alexander Mascola, PT, DPT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

029604 Issued in PA

Practice address

2990 Holme Ave
Philadelphia, PA 19136-1830

Phone

(215) 335-2100

NPI assigned

Mar 10, 2022

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Fox Rehabilitation Services Inc

  • Physical Therapist
  • Wilmington, DE
  • NPI 1326092503

  PA

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1646870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1740937663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N MARSHALL ST UNIT 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191231309",
            "telephone_number": "732-841-0037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2990 HOLME AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191361830",
            "telephone_number": "215-335-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASCOLA",
        "first_name": "KYLE",
        "middle_name": "ALEXANDER",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-10",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NJ",
            "license": "40QA02016100",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "029604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rina Ventura Maschler, PSY.D.
• Abigail Mascia
• Christine Masciarelli, LCSW
• Christopher Edward Mascio, M.D.
• Kara Beth Mascitti, M.D.
• John Masek, CRNA
• Rebecca Hope Masel, MD
• Emily Maseth, DPT
• Max Masgudov, MD
• Megan Mashburn, CRNP

• Physical Medicine & Rehabilitation Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Physical Medicine & Rehabilitation Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.