Individual provider Active NPI

Michael John Spevak, DPT

  • Physical Therapist
  • Reno, NV
National Provider Identifier
1407845043
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1384 Issued in NV
Practice address
3594 W Plumb LN
Suite B
Reno, NV 89509-3696
Phone
(775) 786-2400
Fax
(775) 786-2411
NPI assigned
Oct 17, 2005
Last updated
Jan 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 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 1384 NV Primary

Addresses

Primary practice location

3594 W Plumb LN
Suite B
Reno, NV 89509-3696

Mailing address

3594 W Plumb LN
Suite B
Reno, NV 89509-3696
Phone (775) 786-2400

Other identifiers 1

IdentifierTypeStateIssuer
3416065MedicaidNV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040915000504 NV Practitioner - Physical Therapist in Private Practice 2062489586 Receives reassigned benefits from 1 practitioner
Practice locations: Reno, NV

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3594 W Plumb LN
Suite B
Reno, NV 89509-3087
Phone (775) 786-2400

3594 W Plumb LN B
Reno, NV 89509-3087

Merit-based Incentive Payment System (MIPS)

Final score
21.28 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
70.93

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Partners Nevada LLC Physical Therapist PastSince Jan 1, 2007 Accepting new patients

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1407845043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3594 W PLUMB LN",
            "address_2": "SUITE B",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895093696",
            "telephone_number": "775-786-2400",
            "fax_number": "775-786-2411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3594 W PLUMB LN",
            "address_2": "SUITE B",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895093696",
            "telephone_number": "775-786-2400",
            "fax_number": "775-786-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEVAK",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "1384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3416065",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.