Individual provider Active NPI

Michael James Laviolette II, DPT

  • Physical Therapist
  • Wilbraham, MA
National Provider Identifier
1275051013
Registry record updated Jul 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
23670 Issued in MA
Practice address
70 Post Office Park Ste 7007
Wilbraham, MA 01095-1291
Phone
(413) 273-1435
Fax
(413) 279-1438
NPI assigned
Aug 31, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT293580 CA
Physical Therapist 225100000X 23670 MA Primary

Addresses

Primary practice location

70 Post Office Park Ste 7007
Wilbraham, MA 01095-1291

Mailing address

270 International Cir
San Jose, CA 95119-1130
Phone (408) 972-3517

Other practice location 1

270 International Cir
San Jose, CA 95119
Phone (408) 972-3517

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23670MAMDPhysical Therapist
PT293580CAMDOrthopedic Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1504137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562544000000",
    "number": "1275051013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 INTERNATIONAL CIR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951191130",
            "telephone_number": "408-972-3517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 POST OFFICE PARK STE 7007",
            "city": "WILBRAHAM",
            "state": "MA",
            "postal_code": "010951291",
            "telephone_number": "413-273-1435",
            "fax_number": "413-279-1438"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "270 International Cir",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "95119",
            "country_code": "US",
            "telephone_number": "408-972-3517",
            "fax_number": "408-972-3517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAVIOLETTE",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "name_suffix": "II",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-31",
        "last_updated": "2019-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT293580",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "23670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilbraham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2019; 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.