Individual provider Active NPI

Michael Glaser

  • Physical Therapist
  • Greeley, CO
National Provider Identifier
1386258762
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0000176 Issued in CO
Practice address
4617 W 20TH St Ste 2a
Greeley, CO 80634-3207
Phone
(970) 352-9022
NPI assigned
Sep 3, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 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 0000176 CO Primary

Addresses

Primary practice location

4617 W 20TH St Ste 2a
Greeley, CO 80634-3207

Mailing address

2015 24 1/2 LN SE
Rochester, MN 55904-5874

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0000176COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Physical Therapy, P.C. Physical Therapist CurrentSince Sep 6, 2020 Accepting new patients
Select Physical Therapy Holdings Inc Physical Therapist PastSince Sep 6, 2020 Accepting new patients

Locations

4617 W 20th St
Ste 2A
Greeley, CO 80634
Phone (970) 352-9022

4617 W 20th St
Unit A
Greeley, CO 80634
Phone (970) 352-9022

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": "1599091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1386258762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 24 1/2 LN SE",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559045874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4617 W 20TH ST STE 2A",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806343207",
            "telephone_number": "970-352-9022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASER",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-03",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "0000176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; 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.