Individual provider Active NPI

Michael Ludwell Lea, PT, DPT

  • Physical Therapist
  • Brownsville, TX
National Provider Identifier
1134409097
Registry record updated Oct 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1199702 Issued in TX
Practice address
425 E Los Ebanos Blvd
Suite 100B
Brownsville, TX 78520-8481
Phone
(956) 546-3116
Fax
(956) 546-8793
NPI assigned
Aug 24, 2011
Last updated
Oct 30, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2013

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 1199702 TX Primary

Addresses

Primary practice location

425 E Los Ebanos Blvd
Suite 100B
Brownsville, TX 78520-8481

Mailing address

425 E Los Ebanos Blvd
Suite 100B
Brownsville, TX 78520-8481
Phone (956) 546-3116

Other identifiers 1

IdentifierTypeStateIssuer
308952601MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230228001617 TX Practitioner - Physical Therapist in Private Practice 8224287446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vista JV Partners LLCGroup PAC ID 3274998224, 126 clinicians

Practice addresses (Care Compare)

2100 W White St
Suite 290
Anna, TX 75409-5180
Phone (469) 269-5732

Merit-based Incentive Payment System (MIPS)

Final score
84.26 of 100Reported as group
Quality
89.74
Improvement activities
40
Cost
61.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vista JV Partners LLC Physical Therapist CurrentSince Jun 10, 2024 Accepting new patients
Vista Physical Therapy LLC Physical Therapist Past Accepting new patients

Locations

2100 W White St
Ste 290
Anna, TX 75409
Phone (469) 269-5732

12228 N Central Expy
Ste 300
Dallas, TX 75243
Phone (469) 706-3760

331 Las Colinas Blvd E
Irving, TX 75039
Phone (972) 256-7114

6060 Rocky Point Trl
Ste 100
Lake Worth, TX 76135
Phone (682) 289-9840

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": "1314144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383091200000",
    "number": "1134409097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 E LOS EBANOS BLVD",
            "address_2": "SUITE 100B",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785208481",
            "telephone_number": "956-546-3116",
            "fax_number": "956-546-8793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 E LOS EBANOS BLVD",
            "address_2": "SUITE 100B",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785208481",
            "telephone_number": "956-546-3116",
            "fax_number": "956-546-8793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEA",
        "first_name": "MICHAEL",
        "middle_name": "LUDWELL",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-24",
        "last_updated": "2013-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1199702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "308952601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownsville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2013; 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.