Individual provider Active NPI

Michelle A Vanlaethem, RPT

  • Physical Therapist
  • Woburn, MA
National Provider Identifier
1790734333
Registry record updated Sep 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
17795 Issued in MA
Practice address
200 Unicorn Park Dr Ste 201
Woburn, MA 01801
Phone
(781) 782-1300
Fax
(781) 782-1350
NPI assigned
May 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2018

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 17795 MA Primary

Addresses

Primary practice location

200 Unicorn Park Dr Ste 201
Woburn, MA 01801

Mailing address

200 Unicorn Park Dr Ste 201
Woburn, MA 01801-3342
Phone (781) 782-1300

Other names 1

  • Michelle A Le Compte Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090616000431 MA Practitioner - Physical Therapist in Private Practice 0345136552 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excel Orthopaedic SpecialistsGroup PAC ID 0648241414, 46 clinicians

Practice addresses (Care Compare)

200 Unicorn Park Dr
Suite 201
Woburn, MA 01801-3342
Phone (781) 782-1300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2890NHMDPharmacist
17795MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Excel Orthopaedic Specialists CurrentSince Oct 25, 2011 Accepting new patients
Excel Orthopaedic Specialists Inc Past Accepting new patients
Byron V Hartunian MD PC Past Accepting new patients
Achieve Physical Therapy LLC Physical Therapist PastSince Nov 21, 2010 Accepting new patients
McGovern Physical Therapy Associates LLC Physical Therapist Past Accepting new patients
Excel Orthopaedic Specialists Inc Physical Therapist Past Accepting new patients
Achieve Physical Therapy, PC Physical Therapist Past Accepting new patients

Locations

200 Unicorn Park Dr
Ste 201
Woburn, MA 01801
Phone (781) 782-1300

Organizations & group practices 7

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536192000000",
    "number": "1790734333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 UNICORN PARK DR STE 201",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018013342",
            "telephone_number": "781-782-1300",
            "fax_number": "781-782-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 UNICORN PARK DR STE 201",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "01801",
            "telephone_number": "781-782-1300",
            "fax_number": "781-782-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANLAETHEM",
        "first_name": "MICHELLE",
        "middle_name": "A",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2018-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "17795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "LE COMPTE",
            "middle_name": "A",
            "credential": "RPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Woburn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2018; 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.