Individual provider Active NPI

Michael J. Granado, PT, ATC

  • Physical Therapist
  • Arcadia, CA
National Provider Identifier
1801853916
Registry record updated Apr 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT27259 Issued in CA
Practice address
253 N Santa Anita Ave
Arcadia, CA 91006-3114
Phone
(626) 294-0070
NPI assigned
May 1, 2006
Last updated
Apr 24, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2015

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 PT27259 CA Primary

Addresses

Primary practice location

253 N Santa Anita Ave
Arcadia, CA 91006-3114

Mailing address

253 N Santa Anita Ave
Arcadia, CA 91006-3114
Phone (626) 294-0070

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150609003096 CA Practitioner - Physical Therapist in Private Practice 7416929575 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
Physical Edge Physical Therapy IncGroup PAC ID 6709854508, 6 clinicians

Practice addresses (Care Compare)

253 N Santa Anita Ave
Arcadia, CA 91006-3114
Phone (626) 294-0070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT27259CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Edge Physical Therapy Inc Physical Therapist CurrentSince Apr 15, 2015 Accepting new patients

Locations

253 N Santa Anita Ave
Arcadia, CA 91006
Phone (626) 294-0070

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429833600000",
    "number": "1801853916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "253 N SANTA ANITA AVE",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910063114",
            "telephone_number": "626-294-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "253 N SANTA ANITA AVE",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910063114",
            "telephone_number": "626-294-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANADO",
        "first_name": "MICHAEL",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "credential": "PT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2015-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT27259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2015; 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.