Individual provider Active NPI

Michael J Pino, P.T.

  • Physical Therapist
  • Englewood, FL
National Provider Identifier
1356612147
Registry record updated Mar 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT001619E Issued in PA
Practice address
1111 Drury LN
Englewood, FL 34224-4545
Phone
(941) 474-9371
NPI assigned
Jan 25, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2018

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 PT22787 FL
Physical Therapist 225100000X PT001619E PA Primary

Addresses

Primary practice location

1111 Drury LN
Englewood, FL 34224-4545

Mailing address

1111 Drury LN
Englewood, FL 34224-4545
Phone (941) 474-9371

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT22787FLMDPhysical Therapist
PT001619EPAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dynamic Physical Therapy Physical Therapist Past Accepting new patients
Dynamic Therapy Services of Pennsylvania LLC Physical Therapist Past Accepting new patients

Organizations & group practices 2

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": "1327449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520294400000",
    "number": "1356612147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 DRURY LN",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342244545",
            "telephone_number": "941-474-9371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 DRURY LN",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342244545",
            "telephone_number": "941-474-9371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINO",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-25",
        "last_updated": "2018-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT22787",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT001619E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2018; 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.