Michael Joseph O'Donnell

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 26146 Issued in FL

Practice address

160 NW Central Park PLZ
Suite 108
Port St Lucie, FL 34986-1825

Phone

(772) 621-9313

Fax

(772) 621-9358

NPI assigned

Jun 23, 2008

Last updated

Jan 25, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Networks

• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: michael.j.odonnell@upmcdirect.com

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.

• Premier Physical Therapy & Sports Medicine

  • Physical Therapist
  • Jensen Beach, FL
  • NPI 1265724330
  NPD (past)
• Premier Physical Therapy Sport Medicine Inc

  • Physical Therapist
  • Port St Lucie, FL
  • NPI 1417067844
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1255592291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 NW CENTRAL PARK PLZ",
            "address_2": "SUITE 108",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349861825",
            "telephone_number": "772-621-9313",
            "fax_number": "772-621-9358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 NW CENTRAL PARK PLZ",
            "address_2": "SUITE 108",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349861825",
            "telephone_number": "772-621-9313",
            "fax_number": "772-621-9358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DONNELL",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-23",
        "last_updated": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT019301",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 26146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michael.j.odonnell@upmcdirect.com",
            "affiliation": "N",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physical Therapist in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.