Douglas J. Mallers, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05003202 Issued in IN

Practice address

9602 Coldwater Rd
Suite 102
Fort Wayne, IN 46825-2095

Phone

(260) 489-9887

Fax

(260) 489-9121

NPI assigned

Aug 16, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mallers and Swoverland Orthopaedic Physical TherapyGroup PAC ID 2961464169, 14 clinicians

Practice addresses (Care Compare)

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.

• Mallers & Swoverland Orthopaedic Physical Therapy

  • Physical Therapist
  • Fort Wayne, IN
  • NPI 1700869732

  IN, Physical Therapist

  Medicare reassignment Care Compare group NPD Authorized official
• QHG of Fort Wayne Company, LLC

  • Physical Therapist
  • Fort Wayne, IN
  • NPI 1508967266
  NPD (past)
• Redimed Dekalb LLC

  • General Practice Physician
  • Auburn, IN
  • NPI 1669417457

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289174400000",
    "number": "1952393068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9602 COLDWATER RD",
            "address_2": "SUITE 102",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468252095",
            "telephone_number": "260-489-9887",
            "fax_number": "260-489-9121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9602 COLDWATER RD",
            "address_2": "SUITE 102",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468252095",
            "telephone_number": "260-489-9887",
            "fax_number": "260-489-9121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLERS",
        "first_name": "DOUGLAS",
        "middle_name": "J.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2010-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05003202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200374590A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Make Mi Gorgeous
• Kgatale Siko Malatse
• Jaipal Malhi
• Isa Malik, MD
• Mallers & Swoverland Orthopaedic Physical Therapy
• Katherine Mallers, M.A. CCC-SLP
• Amberly Michele Mallon, M.ED, LAT, ATC
• Bridgit Malone, FNP
• Jazzmen Malone
• Shirley A Malone

• All providers in Fort Wayne, IN
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.