Active NPI
Michael Schroder, DPT
- Physical Therapist
- Fishers, IN
National Provider Identifier
1124259429
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05010036A
- Practice address
- 11681 Brooks School Rd
Unit 1
Fishers, IN 46037-9743 - Phone
- (317) 813-0148
- Fax
- (317) 913-1482
- NPI assigned
- Aug 4, 2009
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05010036A | IN | Primary |
Addresses
Primary practice location
11681 Brooks School Rd
Unit 1
Fishers, IN 46037-9743
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200958090 | Medicaid | IN | |
| P00809400 | Other | IN | RAILROAD MEDICARE PIN |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Bend Orthopaedic Associates, Inc. | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/13070/brand/2/csg/1/fhir/r4
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.
-
- Orthopaedic Surgery Physician
- South Bend, IN
- NPI 1669421277
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1249344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414454400000",
"number": "1124259429",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11681 BROOKS SCHOOL RD",
"address_2": "UNIT 1",
"city": "FISHERS",
"state": "IN",
"postal_code": "460379743",
"telephone_number": "317-813-0148",
"fax_number": "317-913-1482"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHRODER",
"first_name": "MICHAEL",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-08-04",
"last_updated": "2014-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05010036A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200958090",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE PIN",
"identifier": "P00809400",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fishers, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.