Individual provider Active NPI

Michael T Studer, PT, DPT, FAPTA

  • Physical Therapist
  • Las Vegas, NV
National Provider Identifier
1811971815
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4810 Issued in NV
Practice address
2650 N Tenaya Way Ste 180
Las Vegas, NV 89128-1110
Phone
(702) 240-2952
NPI assigned
Dec 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2706 OR
Neurology Physical Therapist 2251N0400X 02706 OR
Neurology Physical Therapist 2251N0400X 4810 NV
Physical Therapist 225100000X 4810 NV Primary

Addresses

Primary practice location

2650 N Tenaya Way Ste 180
Las Vegas, NV 89128-1110

Mailing address

2650 N Tenaya Way Ste 180
Las Vegas, NV 89128-1110
Phone (702) 240-2952

Other identifiers 1

IdentifierTypeStateIssuer
213310MedicaidOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050113000180 OR Practitioner - Physical Therapist in Private Practice 9436107034 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HD EnterprisesGroup PAC ID 7810374048, 13 clinicians

Practice addresses (Care Compare)

123 SW Columbia St
Suite 100
Bend, OR 97702-3609
Phone (541) 241-3061

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4810NVMDDentist
2706ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
HD Enterprises Physical Therapist CurrentSince Apr 22, 2022 Accepting new patients
Northwest Rehabilitation Associates, Inc. Physical Therapist CurrentSince Feb 1, 2005 Accepting new patients
Corvallis Sport and Spine Physical Therapy Inc Physical Therapist PastSince Oct 21, 2022 Accepting new patients

Locations

1012 SW Emkay Dr
Bend, OR 97702
Phone (541) 241-3061

210 W Ellendale Ave
Ste 100
Dallas, OR 97338
Phone (503) 623-2433

3270 Liberty Rd S
Salem, OR 97302
Phone (503) 371-0779

Organizations & group practices 3

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": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1811971815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 N TENAYA WAY STE 180",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891281110",
            "telephone_number": "702-240-2952",
            "fax_number": "702-243-0482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 N TENAYA WAY STE 180",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891281110",
            "telephone_number": "702-240-2952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUDER",
        "first_name": "MICHAEL",
        "middle_name": "T",
        "credential": "PT, DPT, FAPTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "2706",
            "primary": false
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "OR",
            "license": "02706",
            "primary": false
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "NV",
            "license": "4810",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "4810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213310",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2023; 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.