MITCHELL C MAUDER (ATS) – Physical Therapist, NPI 1336647460

MITCHELL C MAUDER (ATS) is a healthcare provider. based in Northwood, Ohio. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials ATS. The NPI Number for MITCHELL C MAUDER (ATS) is 1336647460

Main info

Male
Sole Proprietor
4 Years Of Experience
Accepts Medicare Assignment
Name
MITCHELL C MAUDER (ATS)
NPI
1336647460
Phone
(419) 779-5610
Address
3903 WISE ST
Enumeration Date
23 January 2018
Last Update Date
10 November 2025

Doctor Profile

Medical School Name
UNIVERSITY OF TOLEDO COLLEGE OF MEDICINE
Secondary Phone
2142202468
Graduation Year
2022 (4 years ago)
PAC ID
1052755311
Group Practice PAC ID
9931529062
Professional Enrollment ID
I20240215000364
Address ID
TX752310805DA9301XEXPY411
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness85
Years active:8State licenses:0Digital endpointsOther names

2,243 PHYSICAL THERAPIST IN PRIVATE PRACTICE in OH

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Provider Addresses for MITCHELL C MAUDER (ATS)

  • 3903 WISE ST

    NORTHWOOD, OH 436191736

    Phone: (419) 779-5610

    Type: Mailing

  • Bradner Road, Cedar Creek Woods, Northwood, Wood County, Ohio, 43447:43619, United States

    NORTHWOOD, OH 43619

    Phone: (419) 779-5610

    Type: Location

  • 9301 N CENTRAL EXPY STE 451

    DALLAS, TX 752310832

    Phone: (214) 397-1570

    Type: Mailing

  • 3800 Gaylord Pkwy Ste 710

    Frisco, TX 750349635

    Phone: (214) 220-2468

    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: 2024-02-15

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
I20240215000364IPhysical Therapist In Private PracticeTXTBD

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 43619)

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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: 9931529062View full group profile
NameSpecialtyState
Orthopedic SurgeryTX
Orthopedic SurgeryTX
Physician AssistantTX
Nurse PractitionerLA
P O D I A T R YTX
Physician AssistantTX
Physician AssistantTX
Hand Surgery, Orthopedic SurgeryTX
Physician AssistantTX
Nurse PractitionerTX

Reviews

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Frequently asked questions

What is the 10-digit NPI for MITCHELL C MAUDER (ATS)?
MITCHELL C MAUDER (ATS) — NPI 1336647460 — is the standard way to identify this listing.
Is MITCHELL C MAUDER (ATS) listed as active for patients and plans?
The listing shows MITCHELL C MAUDER (ATS) as active in the NPI system.
What is MITCHELL C MAUDER (ATS)'s specialty?
The listing groups MITCHELL C MAUDER (ATS) with Physical Therapist. Clinical services aligned with this taxonomy classification.
Where should I expect MITCHELL C MAUDER (ATS) on a map?
Expect Northwood, Ohio as a primary anchor for MITCHELL C MAUDER (ATS) unless the record lists multiple sites.
Is the information about MITCHELL C MAUDER (ATS) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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