Michael Donnelly

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

096251 Issued in IA

Practice address

1111 Ansborough Ave
Waterloo, IA 50701

Phone

(319) 433-0130

NPI assigned

Aug 4, 2014

Last updated

Jul 30, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

86.32 of 100Reported as group

Quality

84.44

Promoting interoperability

99

Improvement activities

40

Cost

70.78

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Athletico LTD

  dba Athletico Physical Therapy

  • Physical Therapist
  • Oak Brook, IL
  • NPI 1821085028

  IA

  Medicare reassignment Care Compare group NPD
• Athletico LTD

  dba Athletico Physical Therapy

  • Clinic/Center
  • Lafayette, IN
  • NPI 1053044867

  Physical Therapist

  NPD
• Makovicka Harms Group, PC

  dba Makovicka Physical Therapy

  • Physical Therapist
  • Papillion, NE
  • NPI 1093077000
  NPD (past)

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

{
    "created_epoch": "1407110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1447669528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 OAKMONT LN STE 600C",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595548",
            "telephone_number": "630-575-6250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 ANSBOROUGH AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "50701",
            "telephone_number": "319-433-0130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3830 N 167th Ct",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681168067",
            "country_code": "US",
            "telephone_number": "402-502-2290",
            "fax_number": "402-505-3922",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3830 N 167th Ct",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681168067",
            "country_code": "US",
            "telephone_number": "402-502-2290",
            "fax_number": "402-505-3922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-04",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "3390",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "096251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Physical Therapist in Iowa

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