Individual provider Active NPI

Michael Bart McKaskle, PT

  • Physical Therapist
  • Lubbock, TX
National Provider Identifier
1225032600
Registry record updated Nov 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT1133445 Issued in TX
Practice address
2431 S Loop 289
Lubbock, TX 79423-1519
Phone
(806) 771-8008
Fax
(806) 771-8009
NPI assigned
Jun 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2012

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 PT1133445 TX Primary

Addresses

Primary practice location

2431 S Loop 289
Lubbock, TX 79423-1519

Mailing address

2431 S Loop 289
Lubbock, TX 79423-1519
Phone (806) 771-8008

Other identifiers 5

IdentifierTypeStateIssuer
219904402MedicaidTX
8T1365OtherTXBLUE CROSS BLUE SHIELD
219904401MedicaidTX
141193101OtherTXFIRSTCARE
P00169854OtherTXMEDICARE RAILROAD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100809000458 TX Practitioner - Physical Therapist in Private Practice 1951434182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cole Physical Therapy IncGroup PAC ID 4183670441, 16 clinicians

Practice addresses (Care Compare)

703 Hill Country Dr
Suite 202
Kerrville, TX 78028-6161
Phone (930) 896-4545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT1133445TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cole Physical Therapy Inc Physical Therapist CurrentSince Oct 4, 2021 Accepting new patients
St Davids Heart & Vascular, PLLC Past Accepting new patients
Revive Physical Therapy Inc Past Accepting new patients

Locations

111 Blanco Ave
Ste E
Blanco, TX 78606

1316 S State Highway 16
Fredericksburg, TX 78624
Phone (830) 798-3497

703 Hill Country Dr
Ste 202
Kerrville, TX 78028
Phone (830) 896-4545

443 Ranch Road 1431
Kingsland, TX 78639
Phone (325) 388-2969

113 W Young St
Llano, TX 78643
Phone (830) 798-2082

1004 Marble Heights Dr
#B
Marble Falls, TX 78654
Phone (830) 798-3497

21122 State Highway 71 W
Unit B
Spicewood, TX 78669
Phone (512) 264-9981

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": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352937600000",
    "number": "1225032600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2431 S LOOP 289",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794231519",
            "telephone_number": "806-771-8008",
            "fax_number": "806-771-8009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2431 S LOOP 289",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794231519",
            "telephone_number": "806-771-8008",
            "fax_number": "806-771-8009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKASKLE",
        "first_name": "MICHAEL",
        "middle_name": "BART",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2012-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "PT1133445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "219904402",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8T1365",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "219904401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTCARE",
            "identifier": "141193101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00169854",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; 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.