Active NPI
Michael Anthony Lariccia
- Physical Therapist
- Girard, PA
National Provider Identifier
1215031893
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT000694
- Practice address
- 10081 Ridge Rd
Girard, PA 16417 - Phone
- (814) 774-2630
- Fax
- (814) 774-2719
- NPI assigned
- Sep 12, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT000694 | PA | Primary |
Addresses
Primary practice location
10081 Ridge Rd
Girard, PA 16417
Mailing address
3010 West Lake Rd
Erie, PA 16505-3849
Phone (814) 833-2022
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT000694 | PA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Seth Enterprises I | Physical Therapist | Past | Accepting new patients |
| Seth Enterprises II LLC | Physical Therapist | Past | Accepting new patients |
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, 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": "1158019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215031893",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3010 WEST LAKE RD",
"city": "ERIE",
"state": "PA",
"postal_code": "165053849",
"telephone_number": "814-833-2022",
"fax_number": "814-838-1223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10081 RIDGE RD",
"city": "GIRARD",
"state": "PA",
"postal_code": "16417",
"telephone_number": "814-774-2630",
"fax_number": "814-774-2719"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARICCIA",
"first_name": "MICHAEL",
"middle_name": "ANTHONY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT000694",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Girard, PA
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.