Michael Mirabueno, PT,DPT

Primary specialty

SpecialistTaxonomy code 174400000X

License

40QA01300700 Issued in NJ

Practice address

1175 Roosevelt Ave
Carteret, NJ 07008-1536

Phone

(732) 541-2233

Fax

(732) 541-2237

NPI assigned

Dec 18, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dynamic Peak Physical Therapy PT PtaGroup PAC ID 5698021822, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Dynamic Peak Physical Therapy PT Pta

  • Physical Therapist
  • Rutherford, NJ
  • NPI 1437652476
  Medicare reassignment Care Compare group NPD Authorized official
• Mobile Therapy Services, Inc.

  • Physical Therapist
  • Ocean, NJ
  • NPI 1326495615
  Medicare reassignment NPD
• Proform Physical Therapy LLC

  • Physical Therapist
  • Aberdeen, NJ
  • NPI 1073958351
  Medicare reassignment NPD
• Back2Motion Chiropractic LLC

  • Chiropractor
  • Kinnelon, NJ
  • NPI 1467230888
  NPD
• Proform Physical Therapy LLC

  • Physical Therapist
  • Edison, NJ
  • NPI 1861047854
  NPD
• Carteret Comprehensive Medical Care, P.C.

  • Specialist
  • Monroe, NJ
  • NPI 1497200943
  NPD (past)
• Carteret Comprehensive Medical Care,PC

  • Specialist
  • Edison, NJ
  • NPI 1528140563
  NPD (past)
• Prime Rehabilitation Services, Inc.

  • Physical Therapist
  • Ocean, NJ
  • NPI 1801279054
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1229558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521072000000",
    "number": "1962648170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 MAIN ST",
            "city": "FORDS",
            "state": "NJ",
            "postal_code": "088631514",
            "telephone_number": "732-407-6308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 ROOSEVELT AVE",
            "city": "CARTERET",
            "state": "NJ",
            "postal_code": "070081536",
            "telephone_number": "732-541-2233",
            "fax_number": "732-541-2237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRABUENO",
        "first_name": "MICHAEL",
        "credential": "PT,DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-18",
        "last_updated": "2018-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "40QA01300700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jackeline Martinez, RN
• Pablo Martinez IX, MHS, LCADC
• Leonel Levi Matos, LCSW
• Tahesha McCray
• Jimara Mendoza, LSW
• Antonio P Monterosso, PT
• Caitlyn Murray
• Ifza Mustafa
• N/a
• Pradnya V Naik, PT

• Specialist in Carteret, NJ
• Providers in Carteret, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2018; 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.