Individual provider Active NPI

Michael Borst, DPT, ATC

  • Orthopedic Physical Therapist
  • La Crosse, WI
National Provider Identifier
1235517046
Registry record updated Jun 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
14175 Issued in WI
Practice address
509 Main St
La Crosse, WI 54601
Phone
(608) 351-3049
NPI assigned
May 12, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Student in an Organized Health Care Education/Training Program 390200000X
Orthopedic Physical Therapist 2251X0800X 14175 WI Primary

Addresses

Primary practice location

509 Main St
La Crosse, WI 54601

Mailing address

509 Main St
La Crosse, WI 54601-4004
Phone (608) 351-3049

Other practice location 1

632 11th St N
LA Crosse, WI 54601-3527
Phone (414) 651-7215

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180813001567 WI Practitioner - Physical Therapist in Private Practice 2860740529 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dynamic PT LLCGroup PAC ID 3779948302, 9 clinicians

Practice addresses (Care Compare)

1430 Main St
Onalaska, WI 54650-2835
Phone (608) 351-3049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14175WIMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Roberts & Associates Physical Therapy SC Orthopedic CurrentSince Jul 1, 2018 Accepting new patients
Dynamic PT LLC Orthopedic CurrentSince Feb 19, 2024 Accepting new patients
Roberts & Associates Physical Therapy SC Past Accepting new patients

Locations

2841 Darling Ct
La Crosse, WI 54601
Phone (608) 351-3049

1430 Main St
Onalaska, WI 54650
Phone (608) 351-3049

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, 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": "1431388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529020800000",
    "number": "1235517046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 MAIN ST",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546014004",
            "telephone_number": "608-351-3049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 MAIN ST",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "54601",
            "telephone_number": "608-351-3049"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "632 11th St N",
            "address_purpose": "LOCATION",
            "city": "LA Crosse",
            "state": "WI",
            "postal_code": "546013527",
            "country_code": "US",
            "telephone_number": "414-651-7215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORST",
        "first_name": "MICHAEL",
        "credential": "DPT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-12",
        "last_updated": "2018-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "WI",
            "license": "14175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2018; 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.