Individual provider Active NPI

Michael Edward Brahy, PTA

  • Physical Therapy Assistant
  • Vero Beach, FL
National Provider Identifier
1154660728
Registry record updated Jul 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA23032 Issued in FL
Practice address
3995 Chablis St SW
Vero Beach, FL 32968-3149
Phone
(813) 347-3400
NPI assigned
Feb 1, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA23032 FL Primary
Physical Therapy Assistant 225200000X 10213A AZ

Addresses

Primary practice location

3995 Chablis St SW
Vero Beach, FL 32968-3149

Mailing address

3995 Chablis St SW
Vero Beach, FL 32968-3149
Phone (813) 347-3400

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
10213AAZMDPhysical Therapy Assistant
PTA23032FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1359676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372982400000",
    "number": "1154660728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3995 CHABLIS ST SW",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329683149",
            "telephone_number": "813-347-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3995 CHABLIS ST SW",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329683149",
            "telephone_number": "813-347-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAHY",
        "first_name": "MICHAEL",
        "middle_name": "EDWARD",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-01",
        "last_updated": "2013-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA23032",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AZ",
            "license": "10213A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.