Mackenzie N. Dake, PT
NPI 1639476039ActiveIndividual· Physical Therapist· Paso Robles, CA
Physical Therapist (PT) with San Luis Physical Therapy and Orthopedic Rehabilitation Inc, practicing in Paso Robles, California. Medicare paid $92,405 for services to 227 patients in 2024.
Overview
| NPI | 1639476039 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PT |
| Sole proprietor | No |
| NPI issued | Feb 21, 2011 |
| Last updated in NPPES | Aug 15, 2023 |
| Certified by provider | Aug 15, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | PT37580 | CA |
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 | — |
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Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (CA) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 227 |
|---|---|
| Services billed | 4,360 across 12 procedure codes |
| Paid by Medicare | $92,405 |
Education and affiliations
| Graduation year | 2010 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- San Luis Physical Therapy and Orthopedic Rehabilitation IncSanta Maria, CA · 80 clinicians
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