Individual provider Active NPI

Jeffrey Thomas Andres, PT

  • Physical Therapist
  • Lansing, MI
National Provider Identifier
1023103132
Registry record updated Feb 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501011982 Issued in MI
Practice address
5849 W Saginaw Hwy
Lansing, MI 48917-2460
Phone
(517) 827-8644
Fax
(517) 323-4935
NPI assigned
Oct 4, 2006
Last updated
Feb 17, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2016

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 5501011982 MI Primary

Addresses

Primary practice location

5849 W Saginaw Hwy
Lansing, MI 48917-2460

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
30647OtherMIBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140120000585 MI Practitioner - Physical Therapist in Private Practice 0446488480 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DPT Holdings LLCGroup PAC ID 4688679293, 170 clinicians

Practice addresses (Care Compare)

2520 E Jolly Rd
Suite C
Lansing, MI 48910-5729
Phone (800) 974-4378

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501011982MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Rehabilitation Specialists of Fowlerville, LLC CurrentSince Mar 1, 2020 Accepting new patients
Michigan Rehabilitation Specialists of Fowlerville LLC Physical Therapist CurrentSince Mar 1, 2020 Accepting new patients
DPT Holdings, LLC Physical Therapist CurrentSince Aug 30, 2020 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

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

5700 Jackson Rd
Ann Arbor, MI 48103
Phone (734) 926-4710

1235 S Center Rd
Burton, MI 48509
Phone (800) 977-4378

10078 Lapeer Rd
Ste B
Davison, MI 48423
Phone (810) 653-6200

1429 Flushing Rd
#A
Flushing, MI 48433
Phone (810) 487-9128

2520 E Jolly Rd
Ste C
Lansing, MI 48910
Phone (517) 306-4919

5849 W Saginaw Hwy
Lansing, MI 48917
Phone (517) 827-8644

35376 Van Dyke Ave
Sterling Heights, MI 48312
Phone 8009744378 ext. 1890

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, 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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455667200000",
    "number": "1023103132",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5849 W SAGINAW HWY",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489172460",
            "telephone_number": "517-827-8644",
            "fax_number": "517-323-4935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRES",
        "first_name": "JEFFREY",
        "middle_name": "THOMAS",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2016-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501011982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "30647",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2016; 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.