Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Michael Wirth, DPT

Individual provider Physical Therapist · NPI 1306180583

Dr. Michael Wirth, DPT is a Physical Therapist in Private Practice in Lake Ronkonkoma, New York. Qualified in 2011, 15 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in New York.

Years since qualifying
15
Licensed in
NY
In the registry since
2012
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

See every abbreviation used in this directory →

Practice location Address checks out

650 Hawkins Ave Ste 4
Lake Ronkonkoma, NY 11779-2366
Phone: (631) 981-7422
Fax: (631) 981-2490
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 033990 (NY)

Record details

NPI number1306180583
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorYes
NPI enumeratedNovember 12, 2012
Last updated in NPPESDecember 6, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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