Individual provider Active NPI

Michael David Tabasko, MSPT

  • Physical Therapist
  • Atlanta, GA
National Provider Identifier
1043366321
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P19867 Issued in NC
Practice address
PO Box 932184
Atlanta, GA 31193-3038
Phone
(806) 771-7661
Fax
(806) 771-7661
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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 P19867 NC Primary

Addresses

Primary practice location

PO Box 932184
Atlanta, GA 31193-3038

Mailing address

2819 3Rd St
Boulder, CO 80304-3038
Phone (818) 795-6140

Other practice location 1

2819 3rd St
Boulder, CO 80304-3038
Phone (818) 795-6140

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250805004056 NC Practitioner - Physical Therapist in Private Practice 8224183363 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physio, Inc.Group PAC ID 1456508456, 13 clinicians

Practice addresses (Care Compare)

660 Merrimon Ave
Suite C
Asheville, NC 28804-3567
Phone (828) 348-1780

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Physio, Inc. Physical Therapist CurrentSince May 12, 2025 Accepting new patients
Physio, Inc. Past Accepting new patients

Locations

660 Merrimon Ave
Ste C
Asheville, NC 28804
Phone (800) 922-9280

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1043366321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2819 3RD ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043038",
            "telephone_number": "818-795-6140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 932184",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311933038",
            "telephone_number": "806-771-7661",
            "fax_number": "806-771-7661"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2819 3rd St",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "803043038",
            "country_code": "US",
            "telephone_number": "818-795-6140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TABASKO",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "MSPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P19867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2025; 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.