Individual provider Active NPI

Michael L Basten, PT

  • Physical Therapist
  • Phoenix, AZ
National Provider Identifier
1184616518
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1877 Issued in AZ
Practice address
15410 S Mountain Pkwy
Suite 112
Phoenix, AZ 85044-6691
Phone
(480) 940-8299
Fax
(480) 704-0888
NPI assigned
Aug 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1877 AZ Primary

Addresses

Primary practice location

15410 S Mountain Pkwy
Suite 112
Phoenix, AZ 85044-6691

Mailing address

14834 S 5TH Ave
Phoenix, AZ 85045-0468
Phone (480) 496-0498

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1877AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Foothills Therapy Partners, LLC Physical Therapist PastSince Nov 20, 2021 Accepting new patients
Performance Physical Therapy, LLC Physical Therapist PastSince Oct 1, 2015 Accepting new patients
Orthomed, LLC PastSince Jun 30, 2016 Accepting new patients

Organizations & group practices 3

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": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184616518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14834 S 5TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850450468",
            "telephone_number": "480-496-0498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15410 S MOUNTAIN PKWY",
            "address_2": "SUITE 112",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850446691",
            "telephone_number": "480-940-8299",
            "fax_number": "480-704-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASTEN",
        "first_name": "MICHAEL",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "1877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.