Individual provider Active NPI

Michael Kanavy

  • Physical Therapist
  • Philadelphia, PA
National Provider Identifier
1740956689
Registry record updated Dec 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT029670 Issued in PA
Practice address
1800 JFK Blvd Ste 1800
Philadelphia, PA 19103-7434
Phone
(215) 634-9713
NPI assigned
Aug 20, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2022

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 PT029670 PA Primary
Physical Therapist 225100000X

Addresses

Primary practice location

1800 JFK Blvd Ste 1800
Philadelphia, PA 19103-7434

Mailing address

1311 Mamaroneck Ave Ste 140
White Plains, NY 10605-5224
Phone (914) 294-4050

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210826003737 PA Practitioner - Physical Therapist in Private Practice 0143625285 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Progress Physical Therapy LLCGroup PAC ID 1951530849, 430 clinicians

Practice addresses (Care Compare)

1714 Fairmount Ave
Philadelphia, PA 19130-2812
Phone (267) 606-6923

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings, LLC Physical Therapist CurrentSince Aug 9, 2021 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Aug 9, 2021 Accepting new patients
Progress Physical Therapy LLC Physical Therapist CurrentSince Jan 9, 2023 Accepting new patients
Orthopedic and Sports Physical Therapy Services, Inc. Physical Therapist CurrentSince Jan 9, 2023 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

1311 Mamaroneck Ave
Ste 140
White Plains, NY 10605
Phone (914) 265-4838

2641 Street Rd
Bensalem, PA 19020
Phone (267) 525-0135

1175 Lancaster Ave
Berwyn, PA 19312
Phone (610) 651-8282

1600 Bethlehem Pike
Flourtown, PA 19031
Phone (215) 233-9677

233 E King St
Ste 103
Malvern, PA 19355
Phone (484) 318-7214

101 N Monroe St
Media, PA 19063
Phone (484) 444-0135

1714 Fairmount Ave
Philadelphia, PA 19130
Phone (267) 606-6923

9475 Roosevelt Blvd
Philadelphia, PA 19114
Phone (215) 464-6200

10 Shurs Ln
Ste 101
Philadelphia, PA 19127
Phone (267) 437-2486

1528 Walnut St
Ste 1210
Philadelphia, PA 19102
Phone (215) 839-0989

1919 Chestnut St
Ste 104
Philadelphia, PA 19103
Phone (215) 564-1110

1800 John F Kennedy Blvd
Ste 1800
Philadelphia, PA 19103
Phone (215) 634-9713

118 Townsedge Dr
Quarryville, PA 17566
Phone (717) 806-5126

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": "1629417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1740956689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224",
            "telephone_number": "914-294-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 JFK BLVD STE 1800",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191037434",
            "telephone_number": "215-634-9713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANAVY",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-20",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT029670",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.