Individual provider Active NPI

Melissa A Hayman, DPT

  • Physical Therapist
  • Breckenridge, CO
National Provider Identifier
1053452920
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
17261 Issued in CO
Practice address
122 S Main St.
Unit D
Breckenridge, CO 80424
Phone
(970) 453-3990
NPI assigned
Feb 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070014395 IL
Physical Therapist 225100000X 17261 CO Primary

Addresses

Primary practice location

122 S Main St.
Unit D
Breckenridge, CO 80424

Mailing address

PO Box 5584
Frisco, CO 80443-5584
Phone (970) 453-3990

Other practice location 1

1723 W Madison St
Chicago, IL 60612-2606
Phone (312) 432-0900

Other practice location 2

555 South Park Avenue
Plaza Bldg 2
Breckenridge, CO 80424
Phone (970) 262-7420

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201021001426 CO Practitioner - Physical Therapist in Private Practice 7214121045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Axis Sports Medicine LLCGroup PAC ID 7214188895, 18 clinicians

Practice addresses (Care Compare)

122 S Main St
Suite D
Breckenridge, CO 80424-6209
Phone (970) 453-3990

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1053452920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5584",
            "city": "FRISCO",
            "state": "CO",
            "postal_code": "804435584",
            "telephone_number": "970-453-3990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 S MAIN ST.",
            "address_2": "UNIT D",
            "city": "BRECKENRIDGE",
            "state": "CO",
            "postal_code": "80424",
            "telephone_number": "970-453-3990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1723 W Madison St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606122606",
            "country_code": "US",
            "telephone_number": "312-432-0900",
            "fax_number": "312-432-0922",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "555 South Park Avenue",
            "address_2": "Plaza Bldg 2",
            "address_purpose": "LOCATION",
            "city": "Breckenridge",
            "state": "CO",
            "postal_code": "80424",
            "country_code": "US",
            "telephone_number": "970-262-7420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAYMAN",
        "first_name": "MELISSA",
        "middle_name": "A",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070014395",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "17261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Breckenridge, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; 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.