Individual provider Active NPI

Michael Mastrostefano, PT, OCS, MTC

  • Physical Therapist
  • Falls Church, VA
National Provider Identifier
1457340283
Registry record updated May 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305003855 Issued in VA
Practice address
80 East Jefferson St.
Suite 200
Falls Church, VA 22046-3567
Phone
(703) 237-2000
Fax
(703) 237-2155
NPI assigned
Oct 14, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2019

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 2305003855 VA Primary

Addresses

Primary practice location

80 East Jefferson St.
Suite 200
Falls Church, VA 22046-3567

Mailing address

80 East Jefferson St.
Suite 200
Falls Church, VA 22046-3567
Phone (703) 237-2000

Other identifiers 7

IdentifierTypeStateIssuer
G00957OtherVAMEDICARE PTAN
8367-0001OtherVACAREFIRST BC/BS
010066913OtherVAFIRST HEALTH MEDICAID
194012OtherVAANTHEM
346761200OtherVAUS DEPT.F LABOR
487998OtherVANCPPO
7145603OtherVAMAMSI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100831000623 DC Practitioner - Physical Therapist in Private Practice 0547280760 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bodies in Motion Physical Therapy, LLCGroup PAC ID 4587646393, 10 clinicians

Practice addresses (Care Compare)

80 E Jefferson St
Suite 200
Falls Church, VA 22046-3567
Phone (703) 237-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bodies in Motion Physical Therapy IV, LLC Physical Therapist Current Accepting new patients
Bodies in Motion Physical Therapy III, LLC Physical Therapist CurrentSince Jun 21, 2010 Accepting new patients
Bodies in Motion Physical Therapy, LLC Physical Therapist CurrentSince Jun 4, 2002 Accepting new patients

Locations

4084 University Dr
Ste 103
Fairfax, VA 22030
Phone (703) 896-9999

80 E Jefferson St
Ste 200
Falls Church, VA 22046
Phone (703) 237-2000

803 W Broad St
Ste 600
Falls Church, VA 22046
Phone (703) 237-2000

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": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558051200000",
    "number": "1457340283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 EAST JEFFERSON ST.",
            "address_2": "SUITE 200",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220463567",
            "telephone_number": "703-237-2000",
            "fax_number": "703-237-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 EAST JEFFERSON ST.",
            "address_2": "SUITE 200",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220463567",
            "telephone_number": "703-237-2000",
            "fax_number": "703-237-2155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTROSTEFANO",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PT, OCS, MTC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2019-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305003855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "G00957",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BC/BS",
            "identifier": "8367-0001",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH MEDICAID",
            "identifier": "010066913",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "194012",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT.F LABOR",
            "identifier": "346761200",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPPO",
            "identifier": "487998",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "7145603",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Falls Church, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2019; 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.