Individual provider Active NPI

Michael Wiechec, MPT

  • Physical Therapist
  • Burien, WA
National Provider Identifier
1336356708
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00010436 Issued in WA
Practice address
16259 Sylvester Rd SW
Suite 102
Burien, WA 98166-3049
Phone
(248) 202-0846
NPI assigned
May 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT00010436 WA Primary
Physical Therapist 225100000X 1171678 TX
Physical Therapist 225100000X 5501011573 MI

Addresses

Primary practice location

16259 Sylvester Rd SW
Suite 102
Burien, WA 98166-3049

Mailing address

121 N Jones Rd
Bay City, MI 48708-9167
Phone (248) 202-0846

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150203000456 TX Practitioner - Physical Therapist in Private Practice 4183949738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spero Rehabilitation, LLCGroup PAC ID 5890988216, 53 clinicians

Practice addresses (Care Compare)

23225 Kingsland Blvd
Suite 600
Katy, TX 77494-3705
Phone (281) 395-9090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501011573MIMDPhysical Therapist
1171678TXMDPhysical Therapist
PT00010436WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Spero Rehabilitation LLC Physical Therapist CurrentSince Jan 21, 2015 Accepting new patients
Children'S Hospital Pediatric Associates, Inc Past Accepting new patients
Lynn Jackson, PT, PC Physical Therapist Past Accepting new patients

Locations

5401 La Crosse Ave
Ste 101
Austin, TX 78739
Phone (512) 852-8134

4225 Guadalupe St
Austin, TX 78751
Phone (737) 204-0089

5401 La Crosse Ave
Bldg C
Austin, TX 78739
Phone (512) 852-8134

6012 W William Cannon Dr
Ste C101
Austin, TX 78749
Phone (512) 899-8508

2630 N Mason Rd
Ste A1
Katy, TX 77449
Phone (281) 914-4465

23225 Kingsland Blvd
Ste 600
Katy, TX 77494
Phone (281) 395-9090

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336356708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 N JONES RD",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487089167",
            "telephone_number": "248-202-0846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16259 SYLVESTER RD SW",
            "address_2": "SUITE 102",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981663049",
            "telephone_number": "248-202-0846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIECHEC",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00010436",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1171678",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501011573",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burien, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.