MARY ELIZABETH DAUBERT — NPI 1770839052 (Licensed & Credentialed Physical Therapy Assistant in VIENNA, IL)

CMS-1500 Box 24J / 33a • NPI

1770839052

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

225200000X

Licensed & Credentialed Physical Therapy Assistant

Box 32 Service Location & ZIP+4

5615 US HIGHWAY 45 N, VIENNA, IL, 62995-2002

✓ 9-Digit EDI 837 ZIP+4 (62995-2002)

Practice Phone & Referral Fax

(609) 845-7201

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1770839052 (MARY ELIZABETH DAUBERT) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1770839052` (NPI-1 Individual Practitioner)
Provider / Legal Name	MARY ELIZABETH DAUBERT
Plain-English Specialty	Licensed & Credentialed Physical Therapy Assistant NUCC Code: `225200000X` (Physical Therapy Assistant)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	5615 US HIGHWAY 45 N, VIENNA, IL, 62995-2002
Practice Telephone / Fax	Tel: (609) 845-7201
Administrative Mailing Address	5615 US HIGHWAY 45 N, VIENNA, IL, 62995-2002
Enumeration & Last Sync	Enumerated: 2012-07-24 \| CMS Record Updated: 2012-07-24

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

5615 US HIGHWAY 45 N, VIENNA, IL, 62995-2002

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Plain-English Taxonomy & CMS Crosswalk (225200000X)

What Does Taxonomy Code 225200000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 225200000X translates to:
"Licensed & Credentialed Physical Therapy Assistant"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Physical Therapy Assistant for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (MARY ELIZABETH DAUBERT)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`225200000X` — Physical Therapy Assistant Plain English: Licensed & Credentialed Physical Therapy Assistant	State: IL \| License: `160.003001` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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MARY ELIZABETH DAUBERT (NPI #1770839052)