Individual provider Active NPI

Michael McGraw, DPT

  • Physical Therapist
  • Honesdale, PA
National Provider Identifier
1720496458
Registry record updated Mar 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT023691 Issued in PA
Practice address
214 6TH St Ste a
Honesdale, PA 18431-1801
Phone
(570) 228-2142
Fax
(570) 228-2349
NPI assigned
Jul 25, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X TPT021560 PA
Physical Therapist 225100000X PT023691 PA Primary

Addresses

Primary practice location

214 6TH St Ste a
Honesdale, PA 18431-1801

Mailing address

208 S Main St
Moscow, PA 18444-9135
Phone (570) 842-9323

Other practice location 1

82 N Main St
Suite 1
Carbondale, PA 18407-1914
Phone (570) 282-0200

Other identifiers 1

IdentifierTypeStateIssuer
PT023691OtherPASTATE LICENSURE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140922001864 PA Practitioner - Physical Therapist in Private Practice 1850510975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pivot Physical Therapy of Pennsylvania LLCGroup PAC ID 4981971843, 123 clinicians

Practice addresses (Care Compare)

214 6TH St
Suite a
Honesdale, PA 18431-1801
Phone (570) 228-2142

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TPT021560PAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Pivot Physical Therapy of Pennsylvania, LLC Physical Therapist CurrentSince Jun 1, 2017 Accepting new patients
Dynamic Therapy Services, LLC Physical Therapist Past Accepting new patients

Locations

82 N Main St
Ste 1
Carbondale, PA 18407
Phone (570) 282-0200

214 6th St
Ste A
Honesdale, PA 18431
Phone (570) 228-2142

328 Market St
Lewisburg, PA 17837
Phone (570) 768-4922

417 Grow Ave
Montrose, PA 18801
Phone (570) 278-1101

208 S Main St
Moscow, PA 18444
Phone (570) 842-8191

655 Northern Blvd
South Abington Township, PA 18411
Phone (570) 587-2142

24569 Route 6
#C
Towanda, PA 18848
Phone (570) 265-1111

130 W Main St
Ste 100B
Trappe, PA 19426
Phone (484) 471-6850

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, 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": "1406246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1720496458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 S MAIN ST",
            "city": "MOSCOW",
            "state": "PA",
            "postal_code": "184449135",
            "telephone_number": "570-842-9323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 6TH ST STE A",
            "city": "HONESDALE",
            "state": "PA",
            "postal_code": "184311801",
            "telephone_number": "570-228-2142",
            "fax_number": "570-228-2349"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "82 N Main St",
            "address_2": "Suite 1",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "PA",
            "postal_code": "184071914",
            "country_code": "US",
            "telephone_number": "570-282-0200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCGRAW",
        "first_name": "MICHAEL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-25",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "TPT021560",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT023691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSURE",
            "identifier": "PT023691",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honesdale, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; 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.