Individual provider Active NPI

Michael Vangilder, PT

  • Physical Therapist
  • Encinitas, CA
National Provider Identifier
1750487690
Registry record updated Feb 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
26653 Issued in CA
Practice address
1115 Oceanic Dr
Encinitas, CA 92024-4008
Phone
(760) 803-9750
Fax
(858) 720-0992
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2011

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 26653 CA Primary

Addresses

Primary practice location

1115 Oceanic Dr
Encinitas, CA 92024-4008

Mailing address

1115 Oceanic Dr
Encinitas, CA 92024-4008
Phone (760) 803-9750

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031205000774 CA Practitioner - Physical Therapist in Private Practice 1355246893 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
G3 Physical Therapy and Wellness Center PCGroup PAC ID 6204139744, 15 clinicians

Practice addresses (Care Compare)

227 N El Camino Real
Suite 100
Encinitas, CA 92024-5821
Phone (760) 452-2640

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26653CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
G3 Physical Therapy and Wellness Center PC Physical Therapist CurrentSince Dec 1, 2015 Accepting new patients
Scripps Health Current Accepting new patients
Function for Life PT Inc PastSince Mar 1, 2011 Accepting new patients
Levas Physical & Occupational Therapy Physical Therapist Past Accepting new patients

Locations

227 N El Camino Real
Ste 100
Encinitas, CA 92024
Phone (760) 205-1500

Interoperability endpoints

  • Direct secure messaging: mvangilder359913@scrippshlth.medalliesdirect.net

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296518400000",
    "number": "1750487690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 OCEANIC DR",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920244008",
            "telephone_number": "760-803-9750",
            "fax_number": "858-720-0992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 OCEANIC DR",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920244008",
            "telephone_number": "760-803-9750",
            "fax_number": "858-720-0992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANGILDER",
        "first_name": "MICHAEL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2011-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "26653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encinitas, CA

Sources for this page

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