Individual provider Active NPI

Michael G. Joseph, PT, LAT, ATC

  • Sports Physical Therapist
  • Bryan, TX
National Provider Identifier
1043468515
Registry record updated Jul 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physical TherapistTaxonomy code 2251S0007X
License
1032357 Issued in TX
Practice address
3121 University Dr E Ste 100
Bryan, TX 77802-3499
Phone
(979) 776-0169
Fax
(979) 776-1372
NPI assigned
Sep 8, 2008
Sex
Male
Sole proprietor
No

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.

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Texas Medical Branch at Galveston, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brazos Valley Physicians Alliance 22 clinicians

Practice addresses (Care Compare)

3121 University Dr E
100 Central Texas Sports Medicine and Ort
Bryan, TX 77802-3499
Phone (979) 776-0169

Merit-based Incentive Payment System (MIPS)

Final score
79.62 of 100Reported as group
Quality
58.26
Promoting interoperability
97
Improvement activities
40
Cost
76.3

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090504000656 TX Practitioner - Physical Therapist in Private Practice 6204984040 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1032357TXMDOrthopedic Physical Therapist
AT0961TXMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Brazos Valley Physicians Alliance CurrentSince Jul 1, 2020 Accepting new patients
Brazos Valley Physicians Alliance Sports CurrentSince Jul 1, 2020 Accepting new patients

Locations

3121 University Dr E
Ste 100
Bryan, TX 77802
Phone (979) 776-0169

3201 University Dr E
Ste 3
Bryan, TX 77802
Phone (979) 704-5029

Interoperability endpoints

  • Direct secure messaging: michael.joseph.1@25466.direct.athenahealth.com

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT0961 TX
Orthopedic Physical Therapist 2251X0800X 1032357 TX
Sports Physical Therapist 2251S0007X 1032357 TX Primary

Addresses

NPPES NPI Registry

Primary practice location

3121 University Dr E Ste 100
Bryan, TX 77802-3499

Mailing address

3121 University Dr E Ste 100
Bryan, TX 77802-3499
Phone (979) 776-0169

Other practice location 1

3201 University Dr E
Suite 115
Bryan, TX 77802-3476
Phone (979) 776-0169

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 27, 2020.

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1043468515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3121 UNIVERSITY DR E STE 100",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778023499",
            "telephone_number": "979-776-0169",
            "fax_number": "979-776-1372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3121 UNIVERSITY DR E STE 100",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778023499",
            "telephone_number": "979-776-0169",
            "fax_number": "979-776-1372"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3201 University Dr E",
            "address_2": "Suite 115",
            "address_purpose": "LOCATION",
            "city": "Bryan",
            "state": "TX",
            "postal_code": "778023476",
            "country_code": "US",
            "telephone_number": "979-776-0169",
            "fax_number": "979-776-1372",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "MICHAEL",
        "middle_name": "G.",
        "credential": "PT, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-08",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT0961",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "TX",
            "license": "1032357",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "TX",
            "license": "1032357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

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