Individual provider Active NPI

Michael Anthony Hyland, PT, DPT

  • Physical Therapist
  • Broken Arrow, OK
National Provider Identifier
1871057182
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4636 Issued in OK
Practice address
2603 S 15TH PL
Broken Arrow, OK 74012-7285
Phone
(918) 251-7199
Fax
(539) 777-2501
NPI assigned
Jan 31, 2019
Last updated
Jan 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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 4636 OK Primary

Addresses

Primary practice location

2603 S 15TH PL
Broken Arrow, OK 74012-7285

Mailing address

PO Box 1678
Broken Arrow, OK 74013-1678
Phone (918) 251-7199

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190604001361 OK Practitioner - Physical Therapist in Private Practice 6608109871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hyland Physical Therapy and Wellness LLCGroup PAC ID 7618200874, 5 clinicians

Practice addresses (Care Compare)

2603 S 15TH PL
Broken Arrow, OK 74012-7285
Phone (918) 251-7199

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hyland Physical Therapy and Wellness, LLC Physical Therapist CurrentSince Apr 1, 2019 Accepting new patients

Locations

800 S 9th St
Ste B
Broken Arrow, OK 74012
Phone (918) 251-7199

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": "1548892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1871057182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1678",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740131678",
            "telephone_number": "918-251-7199",
            "fax_number": "539-777-2501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2603 S 15TH PL",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740127285",
            "telephone_number": "918-251-7199",
            "fax_number": "539-777-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYLAND",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-31",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "4636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; 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.