Michael Joseph Iacovelli, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

OPT144700 Issued in CA

Practice address

33 Miller Avenue
Mill Valley, CA 94941

Phone

(415) 380-9242

Fax

(415) 388-7458

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

State University of New York at Buffalo School of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physical Medicine Ctr of Marin, a PT Corp.Group PAC ID 1153583778, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Physical Medicine Ctr of Marin, a PT Corp.

  • Physical Therapist
  • Mill Valley, CA
  • NPI 1013176775
  Medicare reassignment Care Compare group NPD Authorized official
• C H Grieve Inc

  • Physical Therapist
  • San Rafael, CA
  • NPI 1881798452
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831200872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 MILLER AVENUE",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "94941",
            "telephone_number": "415-380-9242",
            "fax_number": "415-388-7458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 MILLER AVENUE",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "94941",
            "telephone_number": "415-380-9242",
            "fax_number": "415-388-7458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IACOVELLI",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "OPT144700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Allphin Hubbell, DNP, FNP-C
• Grace Huber, PT, DPT
• Brenda S Huey, DPT
• Haley Hunter, MA, AMFT
• Lisa Sharon Iacovelli, PT
• Jean Ihle, OTR/L
• Interwoven Clinical Services
• Irene Teper MD Inc
• Irina L Melnik, MD Professional Corporation
• Amy Kathleen Iroz

• Physical Therapist in Mill Valley, CA
• Providers in Mill Valley, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.