Individual provider Active NPI

Miche Nakata, PT,

  • Physical Therapist
  • Gilbert, AZ
National Provider Identifier
1225764343
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
LPT-32456 Issued in AZ
Practice address
5656 S Power Rd Ste 139
Gilbert, AZ 85295-8490
Phone
(480) 272-7797
Fax
(480) 566-8330
NPI assigned
Jul 29, 2022
Last updated
Jul 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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 LPT-32456 AZ Primary

Addresses

Primary practice location

5656 S Power Rd Ste 139
Gilbert, AZ 85295-8490

Mailing address

5656 S Power Rd Ste 139
Gilbert, AZ 85295-8490
Phone (480) 272-7797

Other identifiers 1

IdentifierTypeStateIssuer
32456OtherAZLICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260626003307 AZ Practitioner - Physical Therapist in Private Practice 9436622768 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 20216
Phoenix, AZ 85036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPT-32456AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Recovia LLC Physical Therapist Past Accepting new patients
Roc Physical Therapy, PLLC Physical Therapist PastSince Jan 7, 2019 Accepting new patients
Recovia LLC Past Accepting new patients

Organizations & group practices 4

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": "1659052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1225764343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5656 S POWER RD STE 139",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852958490",
            "telephone_number": "480-272-7797",
            "fax_number": "480-566-8330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5656 S POWER RD STE 139",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852958490",
            "telephone_number": "480-272-7797",
            "fax_number": "480-566-8330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKATA",
        "first_name": "MICHE",
        "credential": "PT,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-29",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-32456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "32456",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; 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.