Active NPI
Michael Dusbabek
- Physical Therapist
- Coeur d'Alene, ID
National Provider Identifier
1932305877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT-1145
- Practice address
- 1103 E Best Ave
Coeur D Alene, ID 83814-4878 - Phone
- (208) 665-3514
- NPI assigned
- Jun 26, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT-1145 | ID | Primary |
Addresses
Primary practice location
1103 E Best Ave
Coeur D Alene, ID 83814-4878
Mailing address
609 S Dollar St
Coeur D Alene, ID 83814-3828
Phone (208) 755-6945
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT-1145 | ID | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576195200000",
"number": "1932305877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "609 S DOLLAR ST",
"city": "COEUR D ALENE",
"state": "ID",
"postal_code": "838143828",
"telephone_number": "208-755-6945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1103 E BEST AVE",
"city": "COEUR D ALENE",
"state": "ID",
"postal_code": "838144878",
"telephone_number": "208-665-3514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUSBABEK",
"first_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-26",
"last_updated": "2019-12-13",
"certification_date": "2019-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ID",
"license": "PT-1145",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coeur d'Alene, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.