Mallory Wanserski, DPT
NPI 1619563863ActiveIndividual· Physical Therapist· Frisco, CO
Physical Therapist (DPT) with Vail Clinic Inc and 1 other group, practicing in Frisco, Colorado. Medicare paid $57,536 for services to 77 patients in 2024.
Overview
| NPI | 1619563863 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DPT |
| Sole proprietor | Yes |
| NPI issued | Dec 11, 2020 |
| Last updated in NPPES | Dec 11, 2020 |
| Certified by provider | Dec 11, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 0017354 | CO |
| Physical Therapist | 225100000X | 15240-24 | WI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (CO) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 77 |
|---|---|
| Services billed | 2,839 across 15 procedure codes |
| Paid by Medicare | $57,536 |
Education and affiliations
| Graduation year | 2020 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical groups
- Vail Clinic IncVail, CO · 119 clinicians
- Axis Sports Medicine LLCBreckenridge, CO · 20 clinicians
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All 33 physical therapists in Frisco · All physical therapists in Colorado