Maverick Physiotherapy LLC
NPI 1073185393ActiveOrganization· Physical Therapist· Saint Paul, MN
Physical Therapist in Saint Paul, Minnesota, registered in NPPES in July 2021. The authorized official on file is Mason Richlen, DPT, PT, Co-Owner. Enrolled in Medicare as part b supplier - physical/occupational therapy group in private practice.
Overview
| NPI | 1073185393 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 15, 2021 |
| Last updated in NPPES | Sep 10, 2021 |
| Certified by provider | Sep 10, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Physical/Occupational Therapy Group in Private Practice (MN) |
|---|
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