Individual provider Active NPI

Michael Stephen Broslawski

  • Physical Therapist
  • Cary, NC
National Provider Identifier
1407671001
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P23686 Issued in NC
Practice address
103 Parkway Office CT
Cary, NC 27518-7428
Phone
(908) 892-6793
NPI assigned
Nov 19, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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 P23686 NC Primary

Addresses

Primary practice location

103 Parkway Office CT
Cary, NC 27518-7428

Mailing address

10531 Hertfordshire CT
Cary, NC 27511-7101
Phone (908) 892-6793

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250130002640 NC Practitioner - Physical Therapist in Private Practice 7618406935 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Activcare Physical Therapy, LLCGroup PAC ID 8628027471, 126 clinicians

Practice addresses (Care Compare)

103 Pkwy CT
Suite 102
Cary, NC 27518
Phone (919) 615-3527

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P23686NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Activcare Physical Therapy, LLC Physical Therapist CurrentSince Dec 16, 2024 Accepting new patients

Locations

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

103 Parkway Office Ct
Cary, NC 27518
Phone (908) 892-6793

166 Springbrook Ave
Ste 201
Clayton, NC 27520
Phone (919) 535-8461

3410 Executive Dr
Ste 205
Raleigh, NC 27609
Phone (919) 322-0042

Interoperability endpoints

  • Direct secure messaging: michael.broslawski.p12@direct.athleticoltd.nextgenshare.com

Organizations & group practices 1

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": "1731974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1407671001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10531 HERTFORDSHIRE CT",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275117101",
            "telephone_number": "908-892-6793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 PARKWAY OFFICE CT",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275187428",
            "telephone_number": "908-892-6793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROSLAWSKI",
        "first_name": "MICHAEL",
        "middle_name": "STEPHEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-19",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P23686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.