NPIMap

Organization Active NPI

Made to Move Physical Therapy, Inc.

  • Physical Therapist
  • El Segundo, CA
National Provider Identifier
1811095318
Registry record updated Sep 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 30266 Issued in CA
Legal business name
MADE TO MOVE PHYSICAL THERAPY, INC.
Practice address
615 N Nash St
Ste # 306
El Segundo, CA 90245-2825
Phone
(310) 535-0008
Fax
(310) 535-0009
NPI assigned
Sep 20, 2006
Last updated
Sep 17, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Michele K McCarthy, MSPT, OCS, CHTNPI 1497848956
Title
Owner/Director
Phone
(310) 535-0008

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT 30266 CA Primary

Addresses

Primary practice location

615 N Nash St
Ste # 306
El Segundo, CA 90245-2825

Mailing address

615 N Nash St
Ste # 306
El Segundo, CA 90245-2825
Phone (310) 535-0008

Other identifiers 1

IdentifierTypeStateIssuer
PT0302660MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20061211000659 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6103825625 Receives reassigned benefits from 7 practitioners
Practice locations: El Segundo, CA
O20100930085237 CA DME Supplier - Independently-Practicing Physical Therapist 6103825625 Practice locations: El Segundo, CA

National Provider Directory

National Provider Directory

Locations

615 N Nash St
Ste 306
El Segundo, CA 90245
Phone (310) 535-0008

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284681600000",
    "number": "1811095318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 N NASH ST",
            "address_2": "STE # 306",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902452825",
            "telephone_number": "310-535-0008",
            "fax_number": "310-535-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N NASH ST",
            "address_2": "STE # 306",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902452825",
            "telephone_number": "310-535-0008",
            "fax_number": "310-535-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADE TO MOVE PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2010-09-17",
        "status": "A",
        "authorized_official_last_name": "MCCARTHY",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "310-535-0008",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSPT, OCS, CHT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 30266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PT0302660",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Segundo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.