Individual provider Active NPI

Michael A Lavin, DPT

  • Physical Therapist
  • Kalispell, MT
National Provider Identifier
1962057224
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTP-PT-LIC-17181 Issued in MT
Practice address
200 E Idaho St Ste a
Kalispell, MT 59901-4117
Phone
(406) 257-5610
Fax
(406) 257-1372
NPI assigned
Aug 5, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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 PTP-PT-LIC-17181 MT Primary

Addresses

Primary practice location

200 E Idaho St Ste a
Kalispell, MT 59901-4117

Mailing address

202 Saint Regis Dr
Kalispell, MT 59901-3732
Phone (406) 212-2869

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190909000937 MT Practitioner - Physical Therapist in Private Practice 4789913237 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Rehabilitation Services LLCGroup PAC ID 1456451533, 12 clinicians

Practice addresses (Care Compare)

175 Commons Loop
Suite 100
Kalispell, MT 59901-1904
Phone (406) 752-7250

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTP-PT-LIC-17181MTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Rehabilitation Services LLC CurrentSince Jan 1, 2024 Accepting new patients
Kalispell Regional Medical Center, Inc PastSince Aug 5, 2019 Accepting new patients

Locations

175 Commons Loop
Ste 100
Kalispell, MT 59901
Phone (406) 751-4200

Organizations & group practices 2

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": "1564963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1962057224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 SAINT REGIS DR",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013732",
            "telephone_number": "406-212-2869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E IDAHO ST STE A",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599014117",
            "telephone_number": "406-257-5610",
            "fax_number": "406-257-1372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVIN",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-05",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "PTP-PT-LIC-17181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalispell, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; 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.