Antonio Mauricio Jr., PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

R1007 Issued in MO

Practice address

3999 Highway PP
Poplar Bluff, MO 63901-9046

Phone

(573) 712-2280

NPI assigned

Jan 14, 2019

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tinsley Home Medical Services LLCGroup PAC ID 6608275334, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Tinsley Home Medical Services, LLC

  • Family Medicine Physician
  • Poplar Bluff, MO
  • NPI 1003406539
  Medicare reassignment Care Compare group NPD
• Southeast Rehabilitation, LLC

  • Physical Therapy Clinic/Center
  • Poplar Bluff, MO
  • NPI 1588848618

  Physical Therapist

  Medicare reassignment NPD
• Select Physical Therapy Holdings, Inc.

  • Physical Therapy Clinic/Center
  • Van Buren, MO
  • NPI 1073235271
  NPD
• Select Physical Therapy Holdings, Inc.

  • Physical Therapy Clinic/Center
  • Poplar Bluff, MO
  • NPI 1336869338
  NPD
• RCB Medical PLLC

  • Pediatrics Physician
  • Beaumont, TX
  • NPI 1124509195
  NPD

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

{
    "created_epoch": "1547424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1992279830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639020003",
            "telephone_number": "573-712-2280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3999 HIGHWAY PP",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639019046",
            "telephone_number": "573-712-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURICIO",
        "first_name": "ANTONIO",
        "name_suffix": "Jr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-14",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "R1007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI LICENSE",
            "identifier": "R1007",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "antoniomauricio@mhccaremail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3999 Highway Pp",
            "city": "Poplar Bluff",
            "state": "MO",
            "country_code": "US",
            "postal_code": "639019046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nicole Joy Mathews
• Ashley Matlock
• Zuleika Danielle Matlock, PTA
• Katherine Matthews, LPN
• Rachel Matthews, MSW
• Dana Rae Maxwell, LCSW
• Kelly Maxwell, PHARMD
• Kaitlee Jade Mayabb
• Steven Kelly Mayse
• Starla Maze

• Physical Therapist in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; 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.