Individual provider Active NPI

Michael George Konoza, MSPT, ATC

  • Physical Therapist
  • Beaufort, SC
National Provider Identifier
1033187604
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2703 Issued in SC
Practice address
1076 Ribaut Rd
Suite102
Beaufort, SC 29902-5476
Phone
(843) 521-1970
Fax
(843) 521-0908
NPI assigned
Mar 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2703 SC Primary

Addresses

Primary practice location

1076 Ribaut Rd
Suite102
Beaufort, SC 29902-5476

Mailing address

605 Ashdale Dr
Beaufort, SC 29907-2517
Phone (843) 522-2909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040210000782 SC Practitioner - Physical Therapist in Private Practice 2961316914 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Sportscare and Physical TherapyGroup PAC ID 0648184937, 11 clinicians

Practice addresses (Care Compare)

1900 Boundary St
Suite 101
Beaufort, SC 29902-6822
Phone (843) 521-1970

Merit-based Incentive Payment System (MIPS)

Final score
94.92 of 100Reported as individual
Quality
89.84
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2703SCMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Sportscare and Physical Therapy Physical Therapist CurrentSince Jan 28, 2002 Accepting new patients
Total Joint and Orthopedic Physical Therapy Physical Therapist CurrentSince Dec 14, 2011 Accepting new patients
Carolina Sportscare and Physical Therapy of Bluffton Physical Therapist PastSince Nov 3, 2003 Accepting new patients

Locations

1076 Ribaut Rd
Ste 102
Beaufort, SC 29902
Phone (843) 521-1970

1900 Boundary St
Ste 101
Beaufort, SC 29902
Phone (843) 521-1970

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214352000000",
    "number": "1033187604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 ASHDALE DR",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299072517",
            "telephone_number": "843-522-2909",
            "fax_number": "843-521-0908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1076 RIBAUT RD",
            "address_2": "SUITE102",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025476",
            "telephone_number": "843-521-1970",
            "fax_number": "843-521-0908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONOZA",
        "first_name": "MICHAEL",
        "middle_name": "GEORGE",
        "credential": "MSPT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2008-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "2703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaufort, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.