Individual provider Active NPI

Michael A Guido, PT

  • Physical Therapist
  • Lakewood, OH
National Provider Identifier
1043338981
Registry record updated Jan 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT004631 Issued in OH
Practice address
11716 Detroit Ave
Lakewood, OH 44107-3002
Phone
(216) 712-7816
Fax
(216) 712-7820
NPI assigned
Mar 27, 2007
Last updated
Jan 22, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2020

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 PT004631 OH Primary

Addresses

Primary practice location

11716 Detroit Ave
Lakewood, OH 44107-3002

Mailing address

11716 Detroit Ave
Lakewood, OH 44107-3002
Phone (216) 712-7816

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071213000307 OH Practitioner - Physical Therapist in Private Practice 5294825337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tremont Functional RehabGroup PAC ID 3072921287, 2 clinicians

Practice addresses (Care Compare)

2401 Scranton Rd
Cleveland, OH 44113-4313
Phone (216) 356-6030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT004631OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tremont Functional Rehab CurrentSince Sep 22, 2023 Accepting new patients
Rehabilitation Consultants, Inc Physical Therapist Past Accepting new patients

Locations

2401 Scranton Rd
Cleveland, OH 44113
Phone (216) 284-3077

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1043338981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11716 DETROIT AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441073002",
            "telephone_number": "216-712-7816",
            "fax_number": "216-712-7820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11716 DETROIT AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441073002",
            "telephone_number": "216-712-7816",
            "fax_number": "216-712-7820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUIDO",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT004631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; 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.