Active NPI
Michael Randazzo
- Physical Therapist
- Burleson, TX
National Provider Identifier
1497905236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1160093
- Practice address
- 1006 Red Cedar Way
Burleson, TX 76028-8319 - Phone
- (817) 764-1251
- NPI assigned
- Sep 30, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1160093 | TX | Primary |
| Physical Therapist | 225100000X | PT008301L | PA |
Addresses
Primary practice location
1006 Red Cedar Way
Burleson, TX 76028-8319
Mailing address
1006 Red Cedar Way
Burleson, TX 76028-8319
Other practice location 1
301 Huguley Blvd
Burleson, TX 76028-7506
Phone (817) 551-5900
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT008301L | PA | MD | Physical Therapist |
| 1160093 | TX | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620691200000",
"number": "1497905236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1006 RED CEDAR WAY",
"city": "BURLESON",
"state": "TX",
"postal_code": "760288319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1006 RED CEDAR WAY",
"city": "BURLESON",
"state": "TX",
"postal_code": "760288319",
"telephone_number": "817-764-1251"
}
],
"practiceLocations": [
{
"address_1": "301 Huguley Blvd",
"address_purpose": "LOCATION",
"city": "Burleson",
"state": "TX",
"postal_code": "760287506",
"country_code": "US",
"telephone_number": "817-551-5900",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RANDAZZO",
"first_name": "MICHAEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-09-30",
"last_updated": "2021-05-11",
"certification_date": "2021-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1160093",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT008301L",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burleson, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.