Michael Gardner, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 30795 Issued in FL

Practice address

3903 Northdale Blvd
Suite 111W
Tampa, FL 33624-1864

Phone

(813) 418-7350

Fax

(813) 265-2504

NPI assigned

Sep 22, 2015

Last updated

Apr 7, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optimal Performance and Physical Therapies Hyde Park LLCGroup PAC ID 9931224367, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Optimal Performance and Physical Therapies Hyde Park LLC

  • Physical Therapist
  • Tampa, FL
  • NPI 1528381621
  Medicare reassignment Care Compare group NPD
• Ethos Health Tampa 1, LLC

  • Multi-Specialty Clinic/Center
  • Tampa, FL
  • NPI 1285126763
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1442880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1144699075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21756 STATE ROAD 54",
            "address_2": "STE 102",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335492905",
            "telephone_number": "813-418-7350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 NORTHDALE BLVD",
            "address_2": "SUITE 111W",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336241864",
            "telephone_number": "813-418-7350",
            "fax_number": "813-265-2504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-22",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 30795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn D. Gardner, LCPC, LMHC
• Linda Marie Amanda Gardner, ARNP, NP-C
• Lindsay Gardner, MD
• Marley Myers Gardner, ARNP
• Mary S Gardner, M.D.
• Muriel Sara Gardner
• Risa Ann Gardner, PH.D.
• Emily Gardyasz, LAT, ATC
• Claudia Annabel Garfias, APRN, FNP-C
• KC Yan Garfield, ARNP

• Physical Therapist in Tampa, FL
• Providers in Tampa, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2022; 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.