Individual provider Active NPI

Michael Lisboa Tiong, DPT

  • Physical Therapist
  • Flint, MI
National Provider Identifier
1487614855
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501011839 Issued in MI
Practice address
1397 S Linden Rd
Suite B
Flint, MI 48532-4194
Phone
(810) 230-9750
Fax
(810) 230-8799
NPI assigned
Mar 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 5501011839 MI Primary

Addresses

Primary practice location

1397 S Linden Rd
Suite B
Flint, MI 48532-4194

Mailing address

2042 Whispering Waters Pass
Flushing, MI 48433-9794
Phone (810) 516-2252

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501011839MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Max Well Therapy L.L.C. Physical Therapist Past Accepting new patients
Max Well Therapy LLC Physical Therapist Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487614855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2042 WHISPERING WATERS PASS",
            "city": "FLUSHING",
            "state": "MI",
            "postal_code": "484339794",
            "telephone_number": "810-516-2252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1397 S LINDEN RD",
            "address_2": "SUITE B",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485324194",
            "telephone_number": "810-230-9750",
            "fax_number": "810-230-8799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIONG",
        "first_name": "MICHAEL",
        "middle_name": "LISBOA",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501011839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.