Individual provider Active NPI

Supriya S Mulik

  • Physical Therapist
  • Phoenixville, PA
National Provider Identifier
1871969410
Registry record updated Feb 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT023984 Issued in PA
Practice address
3000 Balfour Cir
Phoenixville, PA 19460-2144
Phone
(484) 920-6137
NPI assigned
Aug 18, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2016

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 PT023984 PA Primary

Addresses

Primary practice location

3000 Balfour Cir
Phoenixville, PA 19460-2144

Mailing address

602 Brooke Dr
Royersford, PA 19468-1865
Phone (573) 201-6297

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160223001635 PA Practitioner - Physical Therapist in Private Practice 6800191206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

134 Lancaster Ave
Malvern, PA 19355-2123

134 Lancaster Ave
Malvern, PA 19355-2144

1939 Bice Rd
Soddy Daisy, TN 37379-3401

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT023984PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Potential Physical Therapy LLC Physical Therapist CurrentSince Nov 1, 2018 Accepting new patients

Locations

134 Lancaster Ave
Malvern, PA 19355
Phone (610) 249-0001

250 W Lancaster Ave
Ste 220
Paoli, PA 19301
Phone (484) 413-2572

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.

NPI Registry JSON

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

{
    "created_epoch": "1439856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454544000000",
    "number": "1871969410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 BROOKE DR",
            "city": "ROYERSFORD",
            "state": "PA",
            "postal_code": "194681865",
            "telephone_number": "573-201-6297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 BALFOUR CIR",
            "city": "PHOENIXVILLE",
            "state": "PA",
            "postal_code": "194602144",
            "telephone_number": "484-920-6137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULIK",
        "first_name": "SUPRIYA",
        "middle_name": "S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-18",
        "last_updated": "2016-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT023984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenixville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2016; 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.