Individual provider Active NPI

Patrick T Jewett, DPT

  • Physical Therapist
  • Muskegon, MI
National Provider Identifier
1043822356
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501019506 Issued in MI
Practice address
2685 Henry Street
Muskegon, MI 49441-3564
Phone
(231) 755-4404
Fax
(231) 755-7704
NPI assigned
Aug 18, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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 5501019506 MI Primary

Addresses

Primary practice location

2685 Henry Street
Muskegon, MI 49441-3564

Mailing address

18000 Cove Street
Suite 202
Spring Lake, MI 49456-1383
Phone (616) 847-1280

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200825003125 MI Practitioner - Physical Therapist in Private Practice 6507283330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shoreline Sport and Spine PLLC 44 clinicians

Practice addresses (Care Compare)

18000 Cove St
Spring Lake, MI 49456-1383
Phone (616) 847-1280

2685 Henry St
Muskegon, MI 49441-3564
Phone (231) 755-4404

Merit-based Incentive Payment System (MIPS)

Final score
97.76 of 100Reported as group
Quality
100
Promoting interoperability
91
Improvement activities
40
Cost
96.35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501019506MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Shoreline Sport & Spine PLLC Physical Therapist CurrentSince Jan 1, 2025 Accepting new patients
Shoreline Sport & Spine PLLC Physical Therapist CurrentSince Jan 1, 2025 Accepting new patients

Locations

2685 Henry St
Muskegon, MI 49441
Phone (231) 755-4404

5481 E Apple Ave
Ste C
Muskegon, MI 49442
Phone (231) 722-5660

18000 Cove St
Ste 202
Spring Lake, MI 49456
Phone (616) 847-1280

Interoperability endpoints

  • Direct secure messaging: patrick.jewett.1@29636.direct.athenahealth.com

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": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1043822356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18000 COVE STREET",
            "address_2": "SUITE 202",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494561383",
            "telephone_number": "616-847-1280",
            "fax_number": "616-847-1290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2685 HENRY STREET",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494413564",
            "telephone_number": "231-755-4404",
            "fax_number": "231-755-7704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEWETT",
        "first_name": "PATRICK",
        "middle_name": "T",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-18",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501019506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; 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.