MALLORY BOACKLE TASSEFF (PT) – Physical Therapist, NPI 1235821679

MALLORY BOACKLE TASSEFF (PT) is a healthcare provider. based in Birmingham, Alabama. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. PTH8787 (AL). The NPI Number for MALLORY BOACKLE TASSEFF (PT) is 1235821679

Main info

Female
9 Years Of Experience
Accepts Medicare Assignment
Name
MALLORY BOACKLE TASSEFF (PT)
NPI
1235821679
Phone
(205) 408-6600
Address
1130 22ND ST S STE 1000
Enumeration Date
24 May 2023
Last Update Date
24 May 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2054086600
Graduation Year
2017 (9 years ago)
PAC ID
9335506690
Group Practice PAC ID
1355608456
Professional Enrollment ID
I20230601002212
Address ID
AL352426507HO7191XRDXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

1,476 PHYSICAL THERAPIST IN PRIVATE PRACTICE in AL

Provider Addresses for MALLORY BOACKLE TASSEFF (PT)

  • 1130 22ND ST S STE 1000

    BIRMINGHAM, AL 352052881

    Phone: (205) 408-6600

    Type: Mailing

  • 7191 CAHABA VALLEY RD STE 102

    HOOVER, AL 352426507

    Phone: (205) 408-6600

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-06-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230601002212IPhysical Therapist In Private PracticeALTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes88777$0
97140Therapy procedure using manual technique, each 15 minutes53368$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes39365$0
97530Therapy procedure using functional activities5622$0
97161Evaluation for physical therapy, typically 20 minutes4139$0
View full utilization report →

Insurance plans in this area (ZIP 35205)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1355608456View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeAL
Physical Therapist In Private PracticeAL
Physical Therapist In Private PracticeAL
Registered Dietitian Or Nutrition ProfessionalAL
-AL
Physical Therapist In Private PracticeAL
-AL
Physical Therapist In Private PracticeAL
Physical Therapist In Private PracticeMS
Registered Dietitian Or Nutrition ProfessionalAL

Reviews

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Frequently asked questions

Is MALLORY BOACKLE TASSEFF (PT) listed with a National Provider Identifier?
Yes — MALLORY BOACKLE TASSEFF (PT) has NPI 1235821679 on file in the registry.
Is MALLORY BOACKLE TASSEFF (PT) still an active registrant?
MALLORY BOACKLE TASSEFF (PT) carries an active NPI according to the public dataset.
What clinical focus is listed for MALLORY BOACKLE TASSEFF (PT)?
At a glance, MALLORY BOACKLE TASSEFF (PT) is tied to Physical Therapist. Clinical services aligned with this taxonomy classification.
Is MALLORY BOACKLE TASSEFF (PT) associated with Birmingham?
Public fields place MALLORY BOACKLE TASSEFF (PT) around Birmingham, Alabama. Always confirm the exact site before visiting.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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