Individual provider Active NPI

Michael Andaya, P.T.

  • Geriatric Physical Therapist
  • Vero Beach, FL
National Provider Identifier
1578708442
Registry record updated Sep 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Physical TherapistTaxonomy code 2251G0304X
License
20505 Issued in FL
Practice address
910 Regency Square
Vero Beach, FL 32967
Phone
(772) 794-9524
NPI assigned
Dec 8, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical Therapist 2251G0304X 20505 FL Primary

Addresses

Primary practice location

910 Regency Square
Vero Beach, FL 32967

Mailing address

1155 8TH Place
Vero, FL 32960-2143
Phone (772) 567-9327

Other identifiers 1

IdentifierTypeStateIssuer
PT-20505OtherFLPT 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
20505FLMDGeriatric Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1228694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314835200000",
    "number": "1578708442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 8TH PLACE",
            "city": "VERO",
            "state": "FL",
            "postal_code": "329602143",
            "telephone_number": "772-567-9327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 REGENCY SQUARE",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "32967",
            "telephone_number": "772-794-9524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDAYA",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-08",
        "last_updated": "2011-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "FL",
            "license": "20505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "PT-20505",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2011; 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.