Individual provider Active NPI

Michael Ross Vanhara

  • Physical Therapist
  • Mesa, AZ
National Provider Identifier
1487474128
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
2500 S Power Rd Ste 123
Mesa, AZ 85209-6688
Phone
(480) 218-1344
NPI assigned
Oct 16, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 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 Primary

Addresses

Primary practice location

2500 S Power Rd Ste 123
Mesa, AZ 85209-6688

Mailing address

2500 S Power Rd Ste 123
Mesa, AZ 85209-6688

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241108000330 AZ Practitioner - Physical Therapist in Private Practice 3577097930 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Moore Physical Therapy PLCGroup PAC ID 6103815212, 13 clinicians

Practice addresses (Care Compare)

2500 S Power Rd
Suite 123
Mesa, AZ 85209-6688
Phone (480) 218-1344

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Moore Physical Therapy PLC Physical Therapist CurrentSince Nov 4, 2024 Accepting new patients

Locations

6410 S Kings Ranch Rd
Ste 4
Gold Canyon, AZ 85118
Phone (480) 982-7948

2500 S Power Rd
Ste 123
Mesa, AZ 85209
Phone (480) 218-1344

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": "1729036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1487474128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 S POWER RD STE 123",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852096688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 S POWER RD STE 123",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852096688",
            "telephone_number": "480-218-1344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANHARA",
        "first_name": "MICHAEL",
        "middle_name": "ROSS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-10-16",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.