JUSTIN THOMAS MABRY (PA) – Physician Assistant, NPI 1083317440

JUSTIN THOMAS MABRY (PA) is a healthcare provider. based in Galion, Ohio. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 50.008745RX (OH). The NPI Number for JUSTIN THOMAS MABRY (PA) is 1083317440

Main info

Male
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
JUSTIN THOMAS MABRY (PA)
NPI
1083317440
Phone
(419) 961-6020
Address
900 WEDGEWOOD CIR
Enumeration Date
24 March 2023
Last Update Date
21 August 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2604839081
Graduation Year
2023 (3 years ago)
PAC ID
7719334812
Group Practice PAC ID
4183040470
Professional Enrollment ID
I20240515002598
Address ID
OH430261160HI3958XDRXX403
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

5,032 PHYSICIAN ASSISTANT in OH

Provider Addresses for JUSTIN THOMAS MABRY (PA)

  • 900 WEDGEWOOD CIR

    GALION, OH 448338815

    Phone: (419) 961-6020

    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: 2024-05-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20231110002654IPhysician AssistantKYTBD
I20240515002598IPhysician AssistantOHTBD

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 44833)

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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: 4183040470View full group profile
NameSpecialtyState
Physician AssistantNC
Physician AssistantOH
Nurse PractitionerKY
Nurse PractitionerOH
Family PracticeOH
Nurse PractitionerOH
Nurse PractitionerOH
Nurse PractitionerKY
Nurse PractitionerOH
Nurse PractitionerKY

Reviews

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Frequently asked questions

What is the registry number for JUSTIN THOMAS MABRY (PA)?
The registry entry for JUSTIN THOMAS MABRY (PA) shows NPI 1083317440.
Quick check: is JUSTIN THOMAS MABRY (PA) active?
Public NPPES data shows JUSTIN THOMAS MABRY (PA) with an active NPI status right now.
How should patients interpret JUSTIN THOMAS MABRY (PA)'s specialty?
The extract shows Physician Assistant for JUSTIN THOMAS MABRY (PA). Clinical services aligned with this taxonomy classification.
Which community is linked to JUSTIN THOMAS MABRY (PA)?
JUSTIN THOMAS MABRY (PA) shows a connection to Galion, Ohio in registry-derived data.
Why is information missing for JUSTIN THOMAS MABRY (PA)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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