Individual provider Active NPI

Michael J Gilboy, PT

  • Physical Therapist
  • Lake Hallie, WI
National Provider Identifier
1083139398
Registry record updated Apr 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11798-24 Issued in WI
Practice address
2751 Commercial Blvd Ste 5
Lake Hallie, WI 54729-5080
Phone
(800) 974-4378
Fax
(630) 515-1536
NPI assigned
Aug 8, 2017
Last updated
Apr 5, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2026

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 11798-24 WI Primary

Addresses

Primary practice location

2751 Commercial Blvd Ste 5
Lake Hallie, WI 54729-5080

Mailing address

24014 W Renwick Rd Ste 206
Plainfield, IL 60544-8711
Phone (800) 974-4378

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171219000013 WI Practitioner - Physical Therapist in Private Practice 1557629623 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DPT Holdings LLCGroup PAC ID 4688679293, 170 clinicians

Practice addresses (Care Compare)

2751 Commercial Blvd
Suite 5
Lake Hallie, WI 54729-5080
Phone (800) 974-4378

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11798-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
DPT Holdings, LLC Physical Therapist CurrentSince Apr 20, 2026 Accepting new patients
Health Shift Physical Therapy, LLC Physical Therapist Current Accepting new patients

Locations

24014 W Renwick Rd
Ste 206
Plainfield, IL 60544

2751 Commercial Blvd
Ste 5
Lake Hallie, WI 54729

227500 Rib Mountain Dr
Ste 220
Rib Mountain, WI 54401

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": "1502150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775347200000",
    "number": "1083139398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24014 W RENWICK RD STE 206",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605448711",
            "telephone_number": "800-974-4378",
            "fax_number": "630-515-1536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2751 COMMERCIAL BLVD STE 5",
            "city": "LAKE HALLIE",
            "state": "WI",
            "postal_code": "547295080",
            "telephone_number": "800-974-4378",
            "fax_number": "630-515-1536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBOY",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-08",
        "last_updated": "2026-04-05",
        "certification_date": "2026-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "11798-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Hallie, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2026; 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.