MULLIS AND ASSOCIATES PHYSICAL THERAPY, INC. (NPI# 1366685257) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366685257 |
| Entity Type | Organization |
| Organization Name | MULLIS AND ASSOCIATES PHYSICAL THERAPY, INC. |
| Practice Address |
811 Massachusetts Ave Suite 100 Boston MA 02118-2605 |
| Mailing Address |
9 Odonnell Sq 1 Dorchester MA 02122-3211 |
| Practice Telephone | 6175196443 |
| Mailing Telephone | 6175196443 |
| Enumeration Date | 2009-04-08 |
| Last Update Date | 2009-04-08 |
| Authorized Official Name | DR. JONATHAN E MULLIS (PRESIDENT/OWNER) |
| Authorized Official Telephone | 6175196443 |
| Authorized Official Credential | PT, DPT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
15359 | MA | Ambulatory Health Care Facilities |
| Street Address |
811 MASSACHUSETTS AVE SUITE 100 |
| City | BOSTON |
| State | MA |
| Zip Code | 02118-2605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649826165 | Haylie Farr | Physical Therapist | 811 Massachusetts Ave, Boston, MA 02118-2605 | 2019-08-12 |
| 1710446026 | William Young Park | Student in an Organized Health Care Education/Training Program | 811 Massachusetts Ave, Boston, MA 02118-2605 | 2019-03-16 |
| 1275081168 | Jeffrey Leblanc | Physical Therapist | 811 Massachusetts Ave, Boston, MA 02118-2605 | 2016-09-20 |
| 1669877346 | Siusi Remondi | Physical Therapist | 811 Massachusetts Ave, Boston, MA 02118-2605 | 2014-10-24 |
| 1275966012 | Lindsey A Van Den Dungen | Physical Therapist | 811 Massachusetts Ave, Boston, MA 02118-2605 | 2013-08-15 |
| 1982945846 | Gisella Dewan | Physical Therapist | 811 Massachusetts Ave, Boston, MA 02118-2605 | 2013-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649870023 | Carlos E Salazar | Counselor | Hcrc 23 Bradston St., Boston, MA 02118 | 2020-10-27 |
| 1780292607 | Jinal Gandhi | Student in an Organized Health Care Education/Training Program | Shapiro Primary Care, 725 Albany Street, Boston, MA 02118 | 2020-07-16 |
| 1669094777 | German Eduardo Velez | Student in an Organized Health Care Education/Training Program | One Boston Medical Center Place Boston Medical Center, Boston, MA 02118 | 2020-05-12 |
| 1255969895 | Isabela Medeiros Heringer Pereira | Student in an Organized Health Care Education/Training Program | 670 Albany Stree, 4th Floor, Boston, MA 02118 | 2020-03-30 |
| 1033746466 | Karan Sunil Hingorani | Student in an Organized Health Care Education/Training Program | Shapiro Primary Care, 725 Albany Street, Precepting Room, Boston, MA 02118 | 2020-03-25 |
| 1326672791 | Azza Ahmed | Dentist | 635 Albany St. G-744, Boston, MA 02118 | 2020-02-25 |
| 1538707401 | Jane Margolis | Social Worker | 840 Harrison Ave., Dowling 2 South, Boston, MA 02118 | 2019-12-11 |
| 1871134833 | Supontep Teerakanok | Dentist | Henry Goldman School of Dental Medicine, 635 Albany St, Boston, MA 02118 | 2019-10-01 |
| 1750939583 | Qasim Silman Ajmi | Orthopaedic Surgery | Department of Orthopaedic Surgery Boston Medical Center, 850 Harrison Ave Dowling 2 North, Boston, MA 02118 | 2019-08-26 |
| 1922655539 | Jami Ryan Pollard | Physician Assistant | 840 Harrison Avenue, Menino Building, Boston, MA 02118 | 2019-08-20 |
| Find all providers in zip 02118 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952938839 | Jessica Moy Wellness LLC | Clinic/Center | 255 Massachusetts Ave Apt 204, Boston, MA 02115-3511 | 2020-03-23 |
| 1598390940 | The Method Performance and Physical Therapy LLC | Clinic/Center | 378 North St Apt 2, Boston, MA 02113-2143 | 2020-03-05 |
| 1316585482 | Healthworks Med Group of Massachusetts P C | Clinic/Center | 157 Berkeley St, Boston, MA 02116-5108 | 2019-12-19 |
| 1871149583 | Shalom Physical Therapy, LLC | Clinic/Center | 78 Bennington St, Boston, MA 02128-1704 | 2019-08-18 |
| 1992205868 | Maximize Your Mobility LLC | Clinic/Center | 292 Newbury St Ste 317, Boston, MA 02115-2801 | 2018-02-17 |
| 1144745902 | Sustained Fitness LLC | Clinic/Center | 581 Boylston St Ste 404, Boston, MA 02116-3624 | 2017-08-13 |
| 1407395916 | District Physical Therapy & Wellness | Clinic/Center | 9 Earl St, Boston, MA 02127-2532 | 2017-02-16 |
| 1235763327 | Wellest Integrative Health LLC | Clinic/Center | 142 Berkeley St Ste 402, Boston, MA 02116-5100 | 2020-02-27 |
| 1962986166 | Flourish Physical Therapy, LLC | Clinic/Center | 262 Beacon St Ste 5, Boston, MA 02116-1295 | 2018-09-24 |
| 1053823948 | Refresh Physical Therapy LLC | Clinic/Center | 45 School St, Boston, MA 02108-3206 | 2017-10-31 |
| Find all providers in BOSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.