Individual provider Active NPI

Michael Snyder, PT

  • Physical Therapist
  • Phoenix, AZ
National Provider Identifier
1972643096
Registry record updated Mar 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
CP001275T Issued in AZ
Practice address
17233 N Holmes Blvd Ste 1650
Phoenix, AZ 85053-2030
Phone
(602) 547-1836
NPI assigned
Feb 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05007458A IN
Physical Therapist 225100000X CP001275T AZ Primary

Addresses

Primary practice location

17233 N Holmes Blvd Ste 1650
Phoenix, AZ 85053-2030

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223

Other practice location 1

300 Ridge Rd
Munster, IN 46321-1528
Phone (219) 836-0027

Other identifiers 1

IdentifierTypeStateIssuer
CP001275TOtherAZPT COMPACT PRIVILEGE VERIFICATION

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200326001327 AZ Practitioner - Physical Therapist in Private Practice 3173553179 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
86.09 of 100Reported as group
Quality
89.13
Improvement activities
40
Cost
73.57

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CP001275TAZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings of Arizona, LLC Physical Therapist CurrentSince Jan 3, 2022 Accepting new patients
Ideal Rehabilitation LLC Past Accepting new patients
Strength Training Inc PastSince Feb 21, 2020 Accepting new patients

Locations

1485 E Florence Blvd
Ste 105
Casa Grande, AZ 85122
Phone (520) 494-3058

5803 W Northern Ave
Ste 110
Glendale, AZ 85301
Phone (623) 295-3699

380 N Estrella Pkwy
Ste A1
Goodyear, AZ 85338
Phone (480) 455-6266

11209 N Tatum Blvd
Ste B120
Phoenix, AZ 85028
Phone (602) 595-0204

1020 S Harrison Rd
Unit 120
Tucson, AZ 85748
Phone (520) 207-6288

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

Organizations & group practices 3

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": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1972643096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223",
            "fax_number": "630-759-3251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17233 N HOLMES BLVD STE 1650",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850532030",
            "telephone_number": "602-547-1836"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Munster",
            "state": "IN",
            "postal_code": "463211528",
            "country_code": "US",
            "telephone_number": "219-836-0027",
            "fax_number": "219-836-0067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "MICHAEL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05007458A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "CP001275T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT COMPACT PRIVILEGE VERIFICATION",
            "identifier": "CP001275T",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; 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.