MARY ANN MULLANE (PT) – Physical Therapist, NPI 1053986430

MARY ANN MULLANE (PT) is a healthcare provider. based in San mateo, California. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. 32381 (CA). The NPI Number for MARY ANN MULLANE (PT) is 1053986430

Main info

Female
32 Years Of Experience
Accepts Medicare Assignment
Name
MARY ANN MULLANE (PT)
NPI
1053986430
Phone
(858) 722-8187
Address
707 FATHOM DR APT 208
Enumeration Date
26 May 2021
Last Update Date
26 May 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3077349129
Graduation Year
1994 (32 years ago)
PAC ID
4880084318
Group Practice PAC ID
0345242178
Professional Enrollment ID
I20211124000454
Address ID
WY830018657JA120XXAVEX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

389 PHYSICAL THERAPIST IN PRIVATE PRACTICE in WY

Provider Addresses for MARY ANN MULLANE (PT)

  • 707 FATHOM DR APT 208

    SAN MATEO, CA 944041066

    Phone: (858) 722-8187

    Type: Mailing

  • 1090 S HWY 89

    JACKSON, WY 830018511

    Phone: (307) 733-5577

    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: 2021-11-24

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
I20211124000454IPhysical Therapist In Private PracticeWYTBD

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
97140Therapy procedure using manual technique, each 15 minutes47538$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes47445$0
97530Therapy procedure using functional activities24235$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes12326$0
97162Evaluation for physical therapy, typically 30 minutes1715$0
View full utilization report →

Insurance plans in this area (ZIP 94404)

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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: 0345242178View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeWY
-WY
Physical Therapist In Private PracticeID
-WY
Physical Therapist In Private PracticeCO
Physical Therapist In Private PracticeWY
Physical Therapist In Private PracticeUT
Physical Therapist In Private PracticePA
Physical Therapist In Private PracticePA

Reviews

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Frequently asked questions

Can I cross-check MARY ANN MULLANE (PT) using NPI 1053986430?
NPI 1053986430 belongs to MARY ANN MULLANE (PT); compare other details if you need extra assurance.
Is MARY ANN MULLANE (PT) still an active registrant?
MARY ANN MULLANE (PT) carries an active NPI according to the public dataset.
What kind of doctor is MARY ANN MULLANE (PT)?
MARY ANN MULLANE (PT) is associated with Physical Therapist in the directory — Clinical services aligned with this taxonomy classification.
Is MARY ANN MULLANE (PT) located near San Mateo?
MARY ANN MULLANE (PT) currently maps to San Mateo, California in this extract.
Does MARY ANN MULLANE (PT) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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