Individual provider Active NPI

Michael L McFall, RPT

  • Physical Therapist
  • Las Vegas, NM
National Provider Identifier
1396814075
Registry record updated Apr 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1132 Issued in NM
Practice address
932 Gallinas St
Suite 103
Las Vegas, NM 87701-3891
Phone
(505) 425-7762
Fax
(505) 454-0801
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 1132 NM
Physical Therapist 225100000X 1132 NM Primary

Addresses

Primary practice location

932 Gallinas St
Suite 103
Las Vegas, NM 87701-3891

Mailing address

2810 Hot Springs Blvd Ste a
Las Vegas, NM 87701-4119
Phone (505) 425-7762

Other identifiers 1

IdentifierTypeStateIssuer
39185885MedicaidNM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071102000199 NM Practitioner - Physical Therapist in Private Practice 4587751839 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1132NMMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
McFall Physical Therapy, LLC Physical Therapist CurrentSince May 5, 2008 Accepting new patients
Las Vegas Physical Therapy LLC Physical Therapist PastSince Sep 1, 2007 Accepting new patients

Locations

2810 Hot Springs Blvd
Ste A
Las Vegas, NM 87701
Phone (505) 425-7762

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586390400000",
    "number": "1396814075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 HOT SPRINGS BLVD STE A",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877014119",
            "telephone_number": "505-425-7762",
            "fax_number": "505-454-0801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "932 GALLINAS ST",
            "address_2": "SUITE 103",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877013891",
            "telephone_number": "505-425-7762",
            "fax_number": "505-454-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCFALL",
        "first_name": "MICHAEL",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "RPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NM",
            "license": "1132",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "1132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39185885",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2020; 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.