Individual provider Active NPI

Michael Brandon Moseley, P.T.

  • Physical Therapist
  • Baton Rouge, LA
National Provider Identifier
1891705620
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
06695 Issued in LA
Practice address
8624 Briarwood PL
Baton Rouge, LA 70809-5409
Phone
(318) 680-0544
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical Therapist 2251S0007X 06695 LA
Physical Therapist 225100000X 06695 LA Primary

Addresses

Primary practice location

8624 Briarwood PL
Baton Rouge, LA 70809-5409

Mailing address

1007 N 5TH St
Monroe, LA 71201-5530
Phone (318) 680-0544

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050607000941 LA Practitioner - Physical Therapist in Private Practice 3577506815 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Westside Physical Therapy LLCGroup PAC ID 5991030801, 3 clinicians

Practice addresses (Care Compare)

4171 Hwy 1 S
Suite 10
Port Allen, LA 70767-5822
Phone (225) 416-0333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06695LAMDSports Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lewy Physical Therapy Inc Physical Therapist CurrentSince May 31, 2017 Accepting new patients
Total Rehab of Baton Rouge Physical Therapist PastSince Jul 25, 2014 Accepting new patients
Nela Sportcenter, L.L.C. Physical Therapist Past Accepting new patients
Melanie Massey Infant & Toddler LLC Physical Therapist Past Accepting new patients
Melanie Massey Physical Therapy Inc Physical Therapist PastSince Jan 23, 2003 Accepting new patients

Locations

8448 Siegen Ln
Baton Rouge, LA 70810
Phone (225) 757-0164

Organizations & group practices 6

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1891705620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 N 5TH ST",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712015530",
            "telephone_number": "318-680-0544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8624 BRIARWOOD PL",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708095409",
            "telephone_number": "318-680-0544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSELEY",
        "first_name": "MICHAEL",
        "middle_name": "BRANDON",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "LA",
            "license": "06695",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "06695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.