Mitali Mohanan, MPT is a medicare enrolled "Physical Therapist" provider in Mendon, Massachusetts. Her current practice location is
3 Pond St, Mendon, Massachusetts. You can reach out to her office (for appointments etc.) via phone at
(909) 446-5126.
Mitali Mohanan is licensed to practice in Massachusetts (license number 22610) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1255182036.
Healthcare Provider's Profile
Full Name | Mitali Mohanan |
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Gender | Female |
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Speciality | Physical Therapist |
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Location | 3 Pond St, Mendon, Massachusetts |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1255182036
- Provider Enumeration Date: 03/29/2024
- Last Update Date: 03/29/2024
Medicare PECOS Information:
- PECOS PAC ID: 5698213320
- Enrollment ID: I20240813003237
Medical Identifiers
Medical identifiers for Mitali Mohanan such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1255182036 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
225100000X | Physical Therapist | 22610 (Massachusetts) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mitali Mohanan allows following entities to bill medicare on her behalf.
Provider Name | Revitalife Pt Llc |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
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Provider Identifiers | NPI Number: 1225868680 PECOS PAC ID: 4789122417 Enrollment ID: O20240813003179 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mitali Mohanan is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mitali Mohanan, MPT 3 Pond St, Mendon, MA 01756-4500 Ph: (909) 446-5126 | Mitali Mohanan, MPT 3 Pond St, Mendon, MA 01756-4500 Ph: (909) 446-5126 |
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