Individual provider Active NPI

Mandi Elaine Ehlers, MSPT

  • Physical Therapist
  • Soldotna, AK
National Provider Identifier
1891857165
Registry record updated Oct 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1734 Issued in AK
Practice address
108 E Corral Ave
Soldotna, AK 99669-7524
Phone
(907) 260-5893
NPI assigned
Dec 14, 2006
Last updated
Oct 4, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2010

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 1734 AK Primary

Addresses

Primary practice location

108 E Corral Ave
Soldotna, AK 99669-7524

Mailing address

411 Haller St
Kenai, AK 99611-7440
Phone (907) 444-0682

Other names 1

  • Mandi Elaine Bock Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130827000143 AK Practitioner - Physical Therapist in Private Practice 9537302336 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, 1,992 clinicians

Practice addresses (Care Compare)

304 W Evergreen Ave
Suite a
Palmer, AK 99645-6970
Phone (907) 745-8686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1734AKMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Excel Physical Therapy Limited Partnership Physical Therapist Past Accepting new patients
Excel Physical Therapy Limited Partnership Physical Therapist Past Accepting new patients

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, 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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286150400000",
    "number": "1891857165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 HALLER ST",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996117440",
            "telephone_number": "907-444-0682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 E CORRAL AVE",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697524",
            "telephone_number": "907-260-5893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHLERS",
        "first_name": "MANDI",
        "middle_name": "ELAINE",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2010-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "1734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANDI",
            "last_name": "BOCK",
            "middle_name": "ELAINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Soldotna, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2010; 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.