Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mary Ann Mullane, PT

Individual provider Physical Therapist · NPI 1053986430

Mary Ann Mullane, PT is a Physical Therapist in Private Practice in Jackson, Wyoming. Qualified in 1994, 32 years ago. Practices with Excel Physical Therapy LLC, a 9-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
32
Licensed in
CA
In the registry since
2021
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

1090 S Hwy 89
Jackson, WY 83001-8511
Phone: (307) 733-5577
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 32381 (CA)

Record details

NPI number1053986430
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT
Sole proprietorNo
NPI enumeratedMay 26, 2021
Last updated in NPPESMay 26, 2021
Certification dateMay 14, 2021
Mailing address707 Fathom Dr Apt 208, San Mateo, CA 94404-1066

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1994 (32 years in practice)
Group practice Excel Physical Therapy Llc — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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