Individual provider Active NPI

Michael Capps, DPT, GCS

  • Physical Therapist
  • Marblehead, MA
National Provider Identifier
1376919415
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
21865 Issued in MA
Practice address
1 Widger Rd
Marblehead, MA 01945-2146
Phone
(781) 631-8250
NPI assigned
Aug 12, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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 21865 MA Primary

Addresses

Primary practice location

1 Widger Rd
Marblehead, MA 01945-2146

Mailing address

44 Beaverbrook Rd
Burlington, MA 01803-1226
Phone (617) 412-8167

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150914000151 MA Practitioner - Physical Therapist in Private Practice 4688981384 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21865MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehab Ma LLC Physical Therapist CurrentSince Mar 1, 2024 Accepting new patients
Run Life Physical Therapy and Wellness LLC CurrentSince Jan 17, 2021 Accepting new patients
Physical Therapy Services of Flatiron PC Physical Therapist CurrentSince Feb 6, 2024 Accepting new patients

Locations

101 Arch St
Fl 8
Boston, MA 02110
Phone (212) 287-4257

303 Wyman St
Ste 300
Waltham, MA 02451
Phone (781) 330-0577

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": "1439337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1376919415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 BEAVERBROOK RD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018031226",
            "telephone_number": "617-412-8167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WIDGER RD",
            "city": "MARBLEHEAD",
            "state": "MA",
            "postal_code": "019452146",
            "telephone_number": "781-631-8250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPPS",
        "first_name": "MICHAEL",
        "credential": "DPT, GCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-12",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "21865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marblehead, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.