Individual provider Active NPI

Michael Patrick Flannagan Jr.

  • Physical Therapist
  • Oceanside, CA
National Provider Identifier
1194227363
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
305059 Issued in CA
Practice address
737 Vista Grande Way Unit 310
Oceanside, CA 92057-7462
Phone
(954) 562-2590
NPI assigned
Mar 5, 2018
Last updated
Nov 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 305059 CA Primary
Physical Therapy Assistant 225200000X 49204 CA

Addresses

Primary practice location

737 Vista Grande Way Unit 310
Oceanside, CA 92057-7462

Mailing address

1920 NW 105TH Ter
Pembroke Pines, FL 33026-2344

Other practice location 1

1920 NW 105th Ter
Pembroke Pines, FL 33026-2344
Phone (954) 562-2590

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231219000796 CA Practitioner - Physical Therapist in Private Practice 0345690269 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
305059CAMDPhysical Therapist
49204CAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gaspar Physical Therapy a Professional Corporation CurrentSince Nov 3, 2023 Accepting new patients
Tri-City Orthopaedic Surgery Medical Group Inc Physical Therapist CurrentSince Dec 31, 2025 Accepting new patients
Tri City Orthopaedic Surgery Medical Group Inc CurrentSince Dec 31, 2025 Accepting new patients
Gaspar Physical Therapy a Professional Corporation Physical Therapist CurrentSince Nov 3, 2023 Accepting new patients
Tri-City Orthopaedic Surgery Medical Group Inc Physical Therapist Past Accepting new patients

Locations

6102 Avenida Encinas
Ste E
Carlsbad, CA 92011
Phone (760) 634-9750

6121 Paseo del Norte
Carlsbad, CA 92011
Phone (760) 477-1350

6121 Paseo del Norte
Ste 200
Carlsbad, CA 92011
Phone (760) 448-9050

6221 Metropolitan St
Ste 101
Carlsbad, CA 92009
Phone (760) 632-6942

3809 Plaza Dr
Ste 112
Oceanside, CA 92056
Phone (760) 941-2630

3905 Waring Rd
Oceanside, CA 92056
Phone (760) 477-1350

981 Lomas Santa Fe Dr
Ste A
Solana Beach, CA 92075
Phone (858) 794-9995

1958 Via Ctr
Vista, CA 92081
Phone (760) 477-1350

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1520208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1194227363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 NW 105TH TER",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330262344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "737 VISTA GRANDE WAY UNIT 310",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920577462",
            "telephone_number": "954-562-2590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1920 NW 105th Ter",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330262344",
            "country_code": "US",
            "telephone_number": "954-562-2590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLANNAGAN",
        "first_name": "MICHAEL",
        "middle_name": "PATRICK",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-05",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "305059",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "49204",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; 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.