Michael Baumgarten, DPT, ATC
Individual provider Active NPI Physical Therapist · Fruitland, ID
NPI 1770950271 · NPPES record last updated Jan 6, 2020
Key facts
- NPI
- 1770950271
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT-6575 (ID)
- Practice address
- 441 S Whitley Dr
Fruitland, ID 83619-2542 - Phone
- (208) 452-7197
- NPI assigned
- Aug 31, 2015
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Current Physical Therapy Kuna LLC
Practice addresses (Care Compare)
943 N Linder Rd
Suite 104
Kuna, ID 83634-3395
Phone (208) 972-4612
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200330002002 | ID | Practitioner - Physical Therapist in Private Practice | 5698104479 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Current Physical Therapy Meridian | Physical Therapist | Current |
Accepting new patients |
| Current Physical Therapy LLC | Physical Therapist | Current |
Accepting new patients |
| Current Physical Therapy Kuna LLC | Physical Therapist | Current |
Accepting new patients |
Locations
441 S Whitley Dr
Fruitland, ID 83619
Phone (208) 452-7197
2175 N Whitley Dr
Fruitland, ID 83619
Phone (208) 452-0303
943 N Linder Rd
Ste 104
Kuna, ID 83634
Phone (208) 922-1719
1020 N Hickory Ave
Ste 115
Meridian, ID 83642
Phone (208) 314-4988
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | |||
| Physical Therapist | 225100000X | PT-6575 | ID | Yes |
Addresses
Primary practice location
441 S Whitley Dr
Fruitland, ID 83619-2542
Mailing address
441 S Whitley Dr
Fruitland, ID 83619-2542
Phone (208) 452-7197
Other practice location 1
3819 Grandview Dr
Ogden, UT 84403-1939
Phone (303) 910-5974
Other practice location 2
4333 Bell Rd Unit 606
Newburgh, IN 47630-8112
Phone (303) 910-5974
Other providers in Fruitland, ID
- Auralcare Hearing Centers of America, LLC
- Roman J Babij
- Clinton W Baker
- Leaanna Baker
- Donna Viola Batt
- Amy Beitia
- Sage Michele Benintendi-Stringer
- Christina Heninger Benson
- Matthew Joseph Berria
- Cami Lynn Blackburn
All providers in Fruitland, ID · Physical Therapist in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 6, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.