Active NPI
Michael Micco, DPT
- Orthopedic Physical Therapist
- Boston, MA
National Provider Identifier
1487291928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 24108
- Practice address
- 70 Day St Apt 2
Boston, MA 02130-1191 - Phone
- (339) 222-3758
- NPI assigned
- Dec 3, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 24108 | MA | Primary |
Addresses
Primary practice location
70 Day St Apt 2
Boston, MA 02130-1191
Mailing address
70 Day St Apt 2
Boston, MA 02130-1191
Phone (339) 222-3758
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24108 | MA | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1575331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575331200000",
"number": "1487291928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "70 DAY ST APT 2",
"city": "BOSTON",
"state": "MA",
"postal_code": "021301191",
"telephone_number": "339-222-3758"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "70 DAY ST APT 2",
"city": "BOSTON",
"state": "MA",
"postal_code": "021301191",
"telephone_number": "339-222-3758"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICCO",
"first_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-12-03",
"last_updated": "2019-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "MA",
"license": "24108",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.