MR. BRIAN JOHN MAHALARIS (PT) – Physical Therapist, NPI 1063555969

MR. BRIAN JOHN MAHALARIS (PT) is a healthcare provider. based in Jacksonville, Florida. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. PT 20758 (FL). The NPI Number for MR. BRIAN JOHN MAHALARIS (PT) is 1063555969

Main info

Male
Sole Proprietor
24 Years Of Experience
Accepts Medicare Assignment
Name
MR. BRIAN JOHN MAHALARIS (PT)
NPI
1063555969
Phone
(904) 858-7450
Address
11701 SAN JOSE BLVD STE 210
Enumeration Date
14 February 2007
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8003809153
Graduation Year
2002 (24 years ago)
PAC ID
8820235294
Group Practice PAC ID
9032552559
Professional Enrollment ID
I20130503000160
Address ID
FL338527907LA1297XNXXX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

4,633 PHYSICAL THERAPIST IN PRIVATE PRACTICE in FL

Provider Addresses for MR. BRIAN JOHN MAHALARIS (PT)

  • 11701 SAN JOSE BLVD STE 210

    JACKSONVILLE, FL 322230756

    Phone: (904) 858-7450

    Fax: (904) 858-7451

    Mailing address matches the actual address.

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: 2013-05-03

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
I20130503000160IPhysical Therapist In Private PracticeFLTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32223)

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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: 9032552559View full group profile
NameSpecialtyState
Occupational Therapist In Private PracticeFL
Physical Therapist In Private PracticeMI
Occupational Therapist In Private PracticeFL
Physical Therapist In Private PracticeFL
Physical Therapist In Private PracticeIL
Qualified Speech Language PathologistFL
Occupational Therapist In Private PracticeTX
Occupational Therapist In Private PracticeFL
Physical Therapist In Private PracticeTN
Physical Therapist In Private PracticeIL

Reviews

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Frequently asked questions

How is MR. BRIAN JOHN MAHALARIS (PT) identified in CMS data?
CMS-hosted NPPES data lists MR. BRIAN JOHN MAHALARIS (PT) with NPI 1063555969.
Does the file indicate MR. BRIAN JOHN MAHALARIS (PT) is practicing under active NPI?
Directory data currently reports MR. BRIAN JOHN MAHALARIS (PT) as active.
What is MR. BRIAN JOHN MAHALARIS (PT)'s specialty?
The listing groups MR. BRIAN JOHN MAHALARIS (PT) with Physical Therapist. Clinical services aligned with this taxonomy classification.
Does MR. BRIAN JOHN MAHALARIS (PT) list a practice location?
Patients near Jacksonville, Florida may find MR. BRIAN JOHN MAHALARIS (PT) in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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