Organization Active NPI

Metropolitan Physical Therapy

  • Physical Therapy Clinic/Center
  • Lafayette, CO
National Provider Identifier
1174933980
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
9061 Issued in CO
Legal business name
METROPOLITAN PHYSICAL THERAPY
Practice address
489 N US Highway 287 Ste 190
Lafayette, CO 80026-8905
Phone
(303) 665-2405
Fax
(303) 648-6602
NPI assigned
May 1, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

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

Authorized official

Name
Vincent Paul CarmelliniNPI 1609820174
Title
Owner/Therapist
Phone
(303) 665-2405

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 9061 CO Primary

Addresses

Primary practice location

489 N US Highway 287 Ste 190
Lafayette, CO 80026-8905

Mailing address

25 Cody St
Lakewood, CO 80226-1240
Phone (303) 665-2405

Other identifiers 1

IdentifierTypeStateIssuer
18110568MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141115000144 CO Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1557583150 Receives reassigned benefits from 1 practitioner
Practice locations: Lafayette, CO

National Provider Directory

National Provider Directory
Tax ID family
Metropolitan Physical Therapy4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1010 Carbon Ct
Unit F
Erie, CO 80516
Phone (303) 665-2405

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1398902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613433600000",
    "number": "1174933980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 CODY ST",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802261240",
            "telephone_number": "303-665-2405",
            "fax_number": "303-648-6602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 N US HIGHWAY 287 STE 190",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800268905",
            "telephone_number": "303-665-2405",
            "fax_number": "303-648-6602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METROPOLITAN PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-01",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A",
        "authorized_official_last_name": "CARMELLINI",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "303-665-2405"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CO",
            "license": "9061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18110568",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.