Individual provider Active NPI

Michelle Santos Zamora, RPT

  • Physical Therapist
  • Las Vegas, NV
National Provider Identifier
1306135736
Registry record updated Apr 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
33162 Issued in CA
Practice address
10590 Eagle Nest St
Las Vegas, NV 89141-3825
Phone
(702) 835-2901
NPI assigned
Apr 6, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2020

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 33162 CA Primary

Addresses

Primary practice location

10590 Eagle Nest St
Las Vegas, NV 89141-3825

Mailing address

10590 Eagle Nest St
Las Vegas, NV 89141-3825
Phone (702) 835-2901

Other practice location 1

3540 Wilshire Blvd Ste 314
Los Angeles, CA 90010-2347
Phone (213) 389-1141

Other identifiers 2

IdentifierTypeStateIssuer
PT 33162OtherCAPT BOARD OF CALIFORNIA
PT3069OtherNVNEVADA PT BOARD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230614000548 NV Practitioner - Physical Therapist in Private Practice 7416135751 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Las Vegas, NV 89141
Phone (702) 835-2901

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33162CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Good Life Therapy, LLC Physical Therapist CurrentSince May 6, 2023 Accepting new patients
Aspen Meadow Therapy Services LLC Physical Therapist CurrentSince Oct 11, 2023 Accepting new patients
Nevada Rehab Resources LLC Physical Therapist CurrentSince Sep 5, 2023 Accepting new patients
G&H Rehab Inc Physical Therapist PastSince May 26, 2012 Accepting new patients
Vins Physical Therapy Inc Physical Therapist PastSince Jan 2, 2013 Accepting new patients
Care First Physical Therapy Rehab Inc Past Accepting new patients

Organizations & group practices 6

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": "1302048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586304000000",
    "number": "1306135736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10590 EAGLE NEST ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891413825",
            "telephone_number": "702-835-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10590 EAGLE NEST ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891413825",
            "telephone_number": "702-835-2901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3540 Wilshire Blvd Ste 314",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900102347",
            "country_code": "US",
            "telephone_number": "213-389-1141",
            "fax_number": "213-389-1171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZAMORA",
        "first_name": "MICHELLE",
        "middle_name": "SANTOS",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-06",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "33162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT BOARD OF CALIFORNIA",
            "identifier": "PT 33162",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEVADA PT BOARD",
            "identifier": "PT3069",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2020; 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.