Individual provider Active NPI

Melissa Dawn Gaethje, DPT

  • Physical Therapist
  • Phoenix, AZ
National Provider Identifier
1255769873
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10613 Issued in AZ
Practice address
5355 E High St Unit 113
Phoenix, AZ 85054-5481
Phone
(602) 648-5444
Fax
(602) 772-3801
NPI assigned
Oct 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 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 10613 AZ Primary

Addresses

Primary practice location

5355 E High St Unit 113
Phoenix, AZ 85054-5481

Mailing address

PO Box 80217
Phoenix, AZ 85060-0217
Phone (602) 385-2115

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171220000407 AZ Practitioner - Physical Therapist in Private Practice 1456581388 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopedic Specialists of North America PLLCGroup PAC ID 7719014505, 310 clinicians

Practice addresses (Care Compare)

14044 W Camelback Rd
Suite 120
Litchfield Park, AZ 85340-9492
Phone (623) 846-7614

5620 E Bell Rd
Scottsdale, AZ 85254-5950
Phone (602) 385-2115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10613AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Specialists of North America, PLLC Current Accepting new patients
Orthopedic Specialists of North America, PLLC CurrentSince May 2, 2017 Accepting new patients

Locations

10450 W McDowell Rd
Ste 102
Avondale, AZ 85392
Phone (623) 846-7614

7225 W Harrison St
Chandler, AZ 85226
Phone (480) 306-4160

18555 N 79th Ave
Ste E101
Glendale, AZ 85308
Phone (602) 631-3161

20325 N 51st Ave
Ste 150
Glendale, AZ 85308
Phone (602) 795-6300

14044 W Camelback Rd
Ste 126
Litchfield Park, AZ 85340
Phone (623) 846-7614

21465 N 78th Ave
Ste 170
Peoria, AZ 85382
Phone (602) 380-6807

13640 N 7th St
Phoenix, AZ 85022
Phone (602) 493-9361

3033 N 44th St
Ste 100
Phoenix, AZ 85018
Phone (602) 631-3161

5355 E High St
Unit 113
Phoenix, AZ 85054

9219 E Hidden Spur Trl
Ste 100
Scottsdale, AZ 85255
Phone (602) 380-6807

8405 N Pima Center Pkwy
Ste 101
Scottsdale, AZ 85258
Phone (480) 860-1322

5620 E Bell Rd
Scottsdale, AZ 85254
Phone (602) 485-3050

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": "1381881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1255769873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80217",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850600217",
            "telephone_number": "602-385-2115",
            "fax_number": "480-418-3323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5355 E HIGH ST UNIT 113",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850545481",
            "telephone_number": "602-648-5444",
            "fax_number": "602-772-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAETHJE",
        "first_name": "MELISSA",
        "middle_name": "DAWN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-16",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "10613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.