Individual provider Active NPI

Michael Patrick Hannafin, DPT

  • Physical Therapist
  • Nampa, ID
National Provider Identifier
1144030651
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8271046 Issued in ID
Practice address
920 S Rising Sun Dr
Nampa, ID 83686-6000
Phone
(208) 505-8444
Fax
(208) 881-9009
NPI assigned
Jan 8, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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 8271046 ID Primary

Addresses

Primary practice location

920 S Rising Sun Dr
Nampa, ID 83686-6000

Mailing address

920 S Rising Sun Dr
Nampa, ID 83686-6000
Phone (208) 505-8444

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250113001025 ID Practitioner - Physical Therapist in Private Practice 7214465749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

920 S Rising Sun Dr
Nampa, ID 83686-6000
Phone (208) 505-8444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wright Physical Therapy Limited Partnership Physical Therapist CurrentSince Jan 6, 2025 Accepting new patients
Wright Physical Therapy Limited Partnership Physical Therapist CurrentSince Jan 6, 2025 Accepting new patients

Locations

920 S Rising Sun Dr
Nampa, ID 83686
Phone (208) 505-8444

1444 Falls Ave E
Twin Falls, ID 83301
Phone (208) 736-2574

1411 Falls Ave E
Ste 401
Twin Falls, ID 83301
Phone (208) 969-9945

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": "1736294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1144030651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 S RISING SUN DR",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866000",
            "telephone_number": "208-505-8444",
            "fax_number": "208-881-9009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 S RISING SUN DR",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866000",
            "telephone_number": "208-505-8444",
            "fax_number": "208-881-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNAFIN",
        "first_name": "MICHAEL",
        "middle_name": "PATRICK",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-08",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "8271046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; 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.