Individual provider Active NPI

Michael Alan Roberts, PT

  • Physical Therapist
  • Holden, MA
National Provider Identifier
1184699043
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
15425 Issued in MA
Practice address
176 Parker Ave
Holden, MA 01520
Phone
(508) 667-0281
NPI assigned
Feb 22, 2006
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 15425 MA Primary

Addresses

Primary practice location

176 Parker Ave
Holden, MA 01520

Mailing address

176 Parker Ave
Holden, MA 01520
Phone (508) 853-8081

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091013000764 MA Practitioner - Physical Therapist in Private Practice 7012053531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Massachusetts Physical Therapy and Wellness LLCGroup PAC ID 6507903481, 20 clinicians

Practice addresses (Care Compare)

354 W Boylston St
Suite 111
West Boylston, MA 01583-2373
Phone (508) 852-3700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15425MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Massachusetts Physical Therapy and Wellness, LLC Physical Therapist CurrentSince Jun 20, 2007 Accepting new patients
Central Massachusetts Physical Therapy and Wellness, L Current Accepting new patients

Locations

354 W Boylston St
Ste 111
West Boylston, MA 01583
Phone (508) 852-3700

Organizations & group practices 2

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184699043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 PARKER AVE",
            "city": "HOLDEN",
            "state": "MA",
            "postal_code": "01520",
            "telephone_number": "508-853-8081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 PARKER AVE",
            "city": "HOLDEN",
            "state": "MA",
            "postal_code": "01520",
            "telephone_number": "508-667-0281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "MICHAEL",
        "middle_name": "ALAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "15425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holden, MA

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.
  • 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.