Individual provider Active NPI

Michael Scott Freeman, P.T.

  • Physical Therapist
  • Albuquerque, NM
National Provider Identifier
1285917666
Registry record updated Sep 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT005831 Issued in KY
Practice address
505 Elm St NE
Albuquerque, NM 87102-2500
Phone
(717) 437-3312
NPI assigned
Sep 22, 2011
Last updated
Sep 22, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT021284 PA
Physical Therapist 225100000X PT005831 KY Primary

Addresses

Primary practice location

505 Elm St NE
Albuquerque, NM 87102-2500

Mailing address

217 Maple Ave
Gallup, NM 87301-5944
Phone (717) 437-3312

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161011000411 NM Practitioner - Physical Therapist in Private Practice 8729376587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Pittsburgh School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

129 A Canal St
Jemez Pueblo, NM 87024-1542
Phone (575) 834-9168

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4046NMMDAddiction (Substance Use Disorder) Counselor
PT005831KYMDPhysical Therapist
PT021284PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lovelace Unm Rehabilitation Hospital, LLC CurrentSince May 1, 2017 Accepting new patients
Lovelace Unm Rehabilitation Hospital LLC Current Accepting new patients
Lovelace Unm Rehabilitation Hospital LLC Physical Therapist CurrentSince May 1, 2017 Accepting new patients

Locations

505 Elm St NE
Albuquerque, NM 87102
Phone (505) 727-4700

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": "1316649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1285917666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 MAPLE AVE",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015944",
            "telephone_number": "717-437-3312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 ELM ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022500",
            "telephone_number": "717-437-3312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "MICHAEL",
        "middle_name": "SCOTT",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-22",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT021284",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "PT005831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; 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.