Individual provider Active NPI

Michael Christopher Perillo, PT

  • Physical Therapist
  • Tempe, AZ
National Provider Identifier
1316274525
Registry record updated Nov 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8727 Issued in AZ
Practice address
1972 E Baseline Rd Ste 103
Tempe, AZ 85283-1532
Phone
(480) 730-0502
NPI assigned
Nov 9, 2009
Last updated
Nov 9, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2009

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 8727 AZ Primary

Addresses

Primary practice location

1972 E Baseline Rd Ste 103
Tempe, AZ 85283-1532

Mailing address

3303 S Lindsay Rd Ste 116
Gilbert, AZ 85297-2100
Phone (480) 782-9696

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240217000480 NE Practitioner - Physical Therapist in Private Practice 8123158185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

705 N 17TH Ave
Suite 2
Ashland, NE 68003-1209
Phone (402) 944-3505

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lincoln Orthopedic Physical Therapy PC Physical Therapist CurrentSince Mar 18, 2024 Accepting new patients
Lincoln Orthopedic Physical Therapy PC Physical Therapist CurrentSince Mar 18, 2024 Accepting new patients
Dynamic Rehab Hand Therapy, Inc. PastSince Aug 19, 2009 Accepting new patients

Locations

705 N 17th Ave
Ste 2
Ashland, NE 68003
Phone (402) 944-2201

1651 N 86th St
Ste 100
Lincoln, NE 68505
Phone (402) 484-7117

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": "1257724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257724800000",
    "number": "1316274525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3303 S LINDSAY RD STE 116",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852972100",
            "telephone_number": "480-782-9696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1972 E BASELINE RD STE 103",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852831532",
            "telephone_number": "480-730-0502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERILLO",
        "first_name": "MICHAEL",
        "middle_name": "CHRISTOPHER",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-09",
        "last_updated": "2009-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "8727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2009; 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.