Individual provider Active NPI

Michelle Mette Forman, PT, DPT

  • Physical Therapist
  • Reno, NV
National Provider Identifier
1184286015
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3465 Issued in NV
Practice address
9480 Double Diamond Pkwy Ste 200
Reno, NV 89521-5842
Phone
(775) 348-8800
Fax
(833) 687-1419
NPI assigned
Jul 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 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 3465 NV Primary

Addresses

Primary practice location

9480 Double Diamond Pkwy Ste 200
Reno, NV 89521-5842

Mailing address

5310 Kietzke LN Ste 104
Reno, NV 89511-2043
Phone (775) 348-8800

Other identifiers 2

IdentifierTypeStateIssuer
37229OtherCACA LICENSE
3465OtherNVNEVADA STATE LICENSE

Other names 1

  • Michelle Marie Mette Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190812001348 NV Practitioner - Physical Therapist in Private Practice 0840527065 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
James J Lynch M D LTDGroup PAC ID 9133188626, 81 clinicians

Practice addresses (Care Compare)

780 Vista Blvd
Suite 100
Sparks, NV 89434-6677
Phone (775) 348-8800

Merit-based Incentive Payment System (MIPS)

Final score
90.71 of 100Reported as apm
Quality
81.42
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3465NVMDPhysical Therapist

Interoperability endpoints

  • Direct secure messaging: michelle.forman.1@22724.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1561939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1184286015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 KIETZKE LN STE 104",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895112043",
            "telephone_number": "775-348-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9480 DOUBLE DIAMOND PKWY STE 200",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895215842",
            "telephone_number": "775-348-8800",
            "fax_number": "833-687-1419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMAN",
        "first_name": "MICHELLE",
        "middle_name": "METTE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-01",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "3465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA LICENSE",
            "identifier": "37229",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEVADA STATE LICENSE",
            "identifier": "3465",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "METTE",
            "middle_name": "MARIE",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.