Individual provider Active NPI

Teresa Ann Sabotta, DPT

  • Physical Therapist
  • Iron River, MI
National Provider Identifier
1407357080
Registry record updated Feb 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501015310 Issued in MI
Practice address
1400 W Ice Lake Rd
Iron River, MI 49935-9526
Phone
(906) 265-9123
Fax
(906) 265-4335
NPI assigned
Feb 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 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 11645 WI
Physical Therapist 225100000X 5501015310 MI Primary

Addresses

Primary practice location

1400 W Ice Lake Rd
Iron River, MI 49935-9526

Mailing address

155 Pine Landing Rd
Crystal Falls, MI 49920-9171
Phone (906) 367-6526

Other names 1

  • Teresa Ann Colombino Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220830003286 MI Practitioner - Physical Therapist in Private Practice 8921482662 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11645WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Iron River Hospital & Clinics, Inc. CurrentSince May 29, 2022 Accepting new patients
Aspirus Iron River Hospital & Clinics, Inc. CurrentSince May 29, 2022 Accepting new patients
Aspirus Iron River Hospital & Clinics, Inc. Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

814 S Ice Lake Rd
Iron River, MI 49935
Phone (715) 847-2022

1400 W Ice Lake Rd
Iron River, MI 49935
Phone (906) 265-6121

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": "1519776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519776000000",
    "number": "1407357080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 PINE LANDING RD",
            "city": "CRYSTAL FALLS",
            "state": "MI",
            "postal_code": "499209171",
            "telephone_number": "906-367-6526",
            "fax_number": "906-265-4335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 W ICE LAKE RD",
            "city": "IRON RIVER",
            "state": "MI",
            "postal_code": "499359526",
            "telephone_number": "906-265-9123",
            "fax_number": "906-265-4335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SABOTTA",
        "first_name": "TERESA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-28",
        "last_updated": "2018-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "11645",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501015310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "COLOMBINO",
            "middle_name": "ANN",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Iron River, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2018; 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.