Active NPI
Micah James Maly, DPT
- Orthopedic Physical Therapist
- Loveland, CO
National Provider Identifier
1053861666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 0013435
- Practice address
- 730 14TH St SW
Loveland, CO 80537-6349 - Phone
- (970) 663-0815
- NPI assigned
- Oct 6, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 61816 | OR | |
| Physical Therapist | 225100000X | 0013435 | CO | |
| Physical Therapist | 225100000X | 003501 | WV | |
| Physical Therapist | 225100000X | 0000010852 | TN | |
| Orthopedic Physical Therapist | 2251X0800X | 0013435 | CO | Primary |
Addresses
Primary practice location
730 14TH St SW
Loveland, CO 80537-6349
Mailing address
744 Grand Market Ave
Berthoud, CO 80513-2710
Phone (970) 290-5708
Other practice location 1
3325 Pocahontas Rd
Baker City, OR 97814-1464
Phone (541) 523-8130
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61816 | OR | MD | Physical Therapist |
| 0000010852 | TN | MD | Physical Therapist |
| 003501 | WV | MD | Physical Therapist |
| 0013435 | CO | MD | Orthopedic Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Select Physical Therapy Holdings Inc | Physical Therapist | Past | Accepting new patients |
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.
-
- Physical Therapy Clinic/Center
- Englewood, CO
- NPI 1265401897
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664755200000",
"number": "1053861666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "744 GRAND MARKET AVE",
"city": "BERTHOUD",
"state": "CO",
"postal_code": "805132710",
"telephone_number": "970-290-5708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "730 14TH ST SW",
"city": "LOVELAND",
"state": "CO",
"postal_code": "805376349",
"telephone_number": "970-663-0815"
}
],
"practiceLocations": [
{
"address_1": "3325 Pocahontas Rd",
"address_purpose": "LOCATION",
"city": "Baker City",
"state": "OR",
"postal_code": "978141464",
"country_code": "US",
"telephone_number": "541-523-8130",
"fax_number": "541-523-1793",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MALY",
"first_name": "MICAH",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-10-06",
"last_updated": "2022-10-03",
"certification_date": "2022-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "61816",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "0013435",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WV",
"license": "003501",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TN",
"license": "0000010852",
"primary": false
},
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "CO",
"license": "0013435",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Loveland, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.