Individual provider Active NPI

Michelle Roxas Natividad, PT

  • Physical Medicine & Rehabilitation Physician
  • New Rochelle, NY
National Provider Identifier
1740477892
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
028628-1 Issued in NY
Practice address
111 Centre Ave Unit 164
New Rochelle, NY 10801-7276
Phone
(818) 919-8861
NPI assigned
Oct 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 028628 NY
Physical Medicine & Rehabilitation Physician 208100000X 028628-1 NY Primary

Addresses

Primary practice location

111 Centre Ave Unit 164
New Rochelle, NY 10801-7276

Mailing address

111 Centre Ave Unit 164
New Rochelle, NY 10801-7276
Phone (818) 919-8861

Other identifiers 1

IdentifierTypeStateIssuer
028628-1OtherNYLISCENSE

Other names 1

  • Michelle Natividad Lopez Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071228000270 NY Practitioner - Physical Therapist in Private Practice 3274613542 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
028628-1NYMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ally Internal Medicine PC Physical Therapist CurrentSince Jul 30, 2024 Accepting new patients
Total Rehab and Physical Therapy PC Physical Therapist Past Accepting new patients
Maspeth Roura Medical Care PC Past Accepting new patients

Locations

2011 Westchester Ave
Bronx, NY 10462
Phone (516) 764-6464

Organizations & group practices 4

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": "1191283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1740477892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CENTRE AVE UNIT 164",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108017276",
            "telephone_number": "818-919-8861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 CENTRE AVE UNIT 164",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108017276",
            "telephone_number": "818-919-8861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NATIVIDAD",
        "first_name": "MICHELLE",
        "middle_name": "ROXAS",
        "name_prefix": "Miss",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-02",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "028628",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "028628-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LISCENSE",
            "identifier": "028628-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "NATIVIDAD LOPEZ",
            "credential": "PT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in New Rochelle, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.