Individual provider Active NPI

Michelle Marie Peters, PT

  • Physical Therapist
  • Ventura, CA
National Provider Identifier
1700592474
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
303320 Issued in CA
Practice address
1889 Knoll Dr
Ventura, CA 93003-7348
Phone
(805) 644-1591
NPI assigned
Jan 26, 2023
Last updated
Jan 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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 303320 CA Primary

Addresses

Primary practice location

1889 Knoll Dr
Ventura, CA 93003-7348

Mailing address

1889 Knoll Dr
Ventura, CA 93003-7348
Phone (805) 644-1591

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230210000859 CA Practitioner - Physical Therapist in Private Practice 0143692582 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pow Physical Therapy a Professional CorporationGroup PAC ID 1658634043, 6 clinicians

Practice addresses (Care Compare)

1889 Knoll Dr
Ventura, CA 93003-7348
Phone (805) 644-1591

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
303320CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pow Physical Therapy, a Professional Corporation Physical Therapist CurrentSince Feb 2, 2023 Accepting new patients

Locations

1889 Knoll Dr
Ventura, CA 93003
Phone (805) 642-2574

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1674691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1700592474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1889 KNOLL DR",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930037348",
            "telephone_number": "805-644-1591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1889 KNOLL DR",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930037348",
            "telephone_number": "805-644-1591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-26",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "303320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; 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.