Individual provider Active NPI

Michael Anthony Colombo, ATC

  • Physical Therapy Assistant
  • Tucson, AZ
National Provider Identifier
1972512457
Registry record updated Mar 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
Practice address
3945 E. Paradise Falls Dr.
Tucson, AZ 85712
Phone
(520) 321-0204
Fax
(520) 321-0495
NPI assigned
Aug 5, 2006
Last updated
Mar 18, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X AZ Primary
Athletic Trainer 2255A2300X 0578 AZ

Addresses

Primary practice location

3945 E. Paradise Falls Dr.
Tucson, AZ 85712

Mailing address

10571 E Wildfire Dr
Tucson, AZ 85748-3739
Phone (520) 398-7696

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0578AZMDFoot & Ankle Surgery Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268870400000",
    "number": "1972512457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10571 E WILDFIRE DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857483739",
            "telephone_number": "520-398-7696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3945 E. PARADISE FALLS DR.",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85712",
            "telephone_number": "520-321-0204",
            "fax_number": "520-321-0495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLOMBO",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2010-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AZ",
            "license": null,
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "AZ",
            "license": "0578",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.