Individual provider Active NPI

Michael J Willett, PT

  • Physical Therapist
  • Naples, FL
National Provider Identifier
1225042435
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT16338 Issued in FL
Practice address
9051 Tamiami TRL N
Suite 104
Naples, FL 34108-2596
Phone
(239) 591-4711
Fax
(239) 593-1195
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 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 PT16338 FL Primary

Addresses

Primary practice location

9051 Tamiami TRL N
Suite 104
Naples, FL 34108-2596

Mailing address

3633 Country Club Blvd # 1
Cape Coral, FL 33904-4964
Phone (239) 541-3450

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090616000313 FL Practitioner - Physical Therapist in Private Practice 4880657931 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pelican Sports and Rehabilitation of NaplesGroup PAC ID 3375693286, 6 clinicians

Practice addresses (Care Compare)

9051 Tamiami Trail N
Naples, FL 34108-2520
Phone (239) 591-4711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pelican Sports & Rehabilitation of Naples Physical Therapist CurrentSince Jun 1, 2009 Accepting new patients
Pelican Sports and Rehabilitation, Inc Physical Therapist Past Accepting new patients

Locations

9051 Tamiami Trl N
Ste 104
Naples, FL 34108
Phone (239) 591-4711

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1225042435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3633 COUNTRY CLUB BLVD # 1",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339044964",
            "telephone_number": "239-541-3450",
            "fax_number": "239-593-1195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9051 TAMIAMI TRL N",
            "address_2": "SUITE 104",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341082596",
            "telephone_number": "239-591-4711",
            "fax_number": "239-593-1195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLETT",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT16338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.