Individual provider Active NPI

Michelle Fettig, DPT

  • Physical Therapist
  • Tempe, AZ
National Provider Identifier
1962170241
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
31952 Issued in AZ
Practice address
1844 E Baseline Rd Ste C5
Tempe, AZ 85283-1506
Phone
(808) 331-0054
Fax
(480) 833-1312
NPI assigned
Sep 1, 2021
Last updated
Apr 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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 31952 AZ Primary

Addresses

Primary practice location

1844 E Baseline Rd Ste C5
Tempe, AZ 85283-1506

Mailing address

1940 E Pegasus Dr
Tempe, AZ 85283-3237
Phone (480) 528-0631

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211026003544 AZ Practitioner - Physical Therapist in Private Practice 3870981707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Petersen Physical Therapy PCGroup PAC ID 5991794117, 14 clinicians

Practice addresses (Care Compare)

1844 E Baseline Rd
Suite C5
Tempe, AZ 85283-1506
Phone (480) 833-1005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31952AZMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Petersen Physical Therapy PC CurrentSince Mar 26, 2024 Accepting new patients

Locations

21300 N John Wayne Pkwy
Ste 125
Maricopa, AZ 85139
Phone (520) 568-2723

1844 E Baseline Rd
Ste C5
Tempe, AZ 85283
Phone (480) 833-1005

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": "1630454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1962170241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 E PEGASUS DR",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852833237",
            "telephone_number": "480-528-0631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1844 E BASELINE RD STE C5",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852831506",
            "telephone_number": "808-331-0054",
            "fax_number": "480-833-1312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETTIG",
        "first_name": "MICHELLE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-01",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "31952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2026; 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.