Individual provider Active NPI

Michael Van Portfliet, DPT

  • Physical Therapist
  • Centennial, CO
National Provider Identifier
1871975169
Registry record updated Jun 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0013420 Issued in CO
Practice address
6840 S University Blvd Ste 400
Centennial, CO 80122-1510
Phone
(303) 771-5120
NPI assigned
Jun 23, 2015
Last updated
Jun 23, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 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 0013420 CO Primary

Addresses

Primary practice location

6840 S University Blvd Ste 400
Centennial, CO 80122-1510

Mailing address

6840 S University Blvd Ste 400
Centennial, CO 80122-1510
Phone (303) 771-5120

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150904001841 CO Practitioner - Physical Therapist in Private Practice 9739495789 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mend PLLCGroup PAC ID 4284945791, 11 clinicians

Practice addresses (Care Compare)

2760 29TH St
Suite 1B
Boulder, CO 80301-1221
Phone (720) 772-6780

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Physical Therapy, P.C. Physical Therapist Current Accepting new patients
Movewell Physical Therapy Colorado Current Accepting new patients
Mend PLLC Physical Therapist CurrentSince Sep 1, 2018 Accepting new patients
Denver Physical Therapy, P.C. Physical Therapist CurrentSince Jun 19, 2015 Accepting new patients
Denver Physical Therapy, P.C. Physical Therapist CurrentSince Jun 19, 2015 Accepting new patients

Locations

2760 29th St
Ste 1B
Boulder, CO 80301
Phone (720) 772-6780

6840 S University Blvd
Ste 400
Centennial, CO 80122
Phone (303) 771-5120

7310 S Alton Way
Ste 6L
Centennial, CO 80112
Phone (303) 790-4495

Organizations & group practices 5

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": "1435017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435017600000",
    "number": "1871975169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6840 S UNIVERSITY BLVD STE 400",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801221510",
            "telephone_number": "303-771-5120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6840 S UNIVERSITY BLVD STE 400",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801221510",
            "telephone_number": "303-771-5120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN PORTFLIET",
        "first_name": "MICHAEL",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-23",
        "last_updated": "2015-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "0013420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.