Individual provider Active NPI

Charles Michael Shapiro, PT

  • Physical Therapist
  • Hollywood, FL
National Provider Identifier
1508998436
Registry record updated Aug 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT0002021 Issued in FL
Practice address
3850 Sheridan St
Hollywood, FL 33021-3634
Phone
(954) 989-5255
Fax
(954) 962-6445
NPI assigned
Mar 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2012

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 PT0002021 FL Primary

Addresses

Primary practice location

3850 Sheridan St
Hollywood, FL 33021-3634

Mailing address

3850 Sheridan St
Hollywood, FL 33021-3634
Phone (954) 989-5255

Other identifiers 1

IdentifierTypeStateIssuer
PT0002021OtherFLFL PT LICENSE

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
PT0002021FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
North Dade Physical Therapy, Inc. Physical Therapist CurrentSince Jan 1, 2012 Accepting new patients
Lake Mary Physical Therapy, Inc. Physical Therapist PastSince Jan 10, 2000 Accepting new patients
Behnam Myers DO PA PastSince Mar 12, 2016 Accepting new patients

Locations

18690 NW 2nd Ave
Miami Gardens, FL 33169
Phone (305) 652-2005

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": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346284800000",
    "number": "1508998436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3850 SHERIDAN ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213634",
            "telephone_number": "954-989-5255",
            "fax_number": "954-962-6445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 SHERIDAN ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213634",
            "telephone_number": "954-989-5255",
            "fax_number": "954-962-6445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPIRO",
        "first_name": "CHARLES",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT0002021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL PT LICENSE",
            "identifier": "PT0002021",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2012; 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.