Individual provider Active NPI

Marc William Hinze, M.P.T.

  • Physical Therapist
  • Kalamazoo, MI
National Provider Identifier
1104866573
Registry record updated Jan 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501011803 Issued in MI
Practice address
4613 W Main St
Suite C
Kalamazoo, MI 49006-2645
Phone
(269) 488-8360
Fax
(269) 488-8359
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2011

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 5501011803 MI Primary

Addresses

Primary practice location

4613 W Main St
Suite C
Kalamazoo, MI 49006-2645

Mailing address

4613 W Main St
Suite C
Kalamazoo, MI 49006-2645
Phone (269) 488-8360

Other identifiers 3

IdentifierTypeStateIssuer
650C901900OtherMIBCBS
155812OtherGREAT LAKES HLTH PLAN
7173604OtherAETNA PIN

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Midwest PC Past Accepting new patients
Healthcare Midwest PC Past Accepting new patients
Healthcare Midwest PC Past Accepting new patients
Healthcare Midwest PC Physical Therapist Past Accepting new patients
Healthcare Midwest PC Past Accepting new patients
Healthcare Midwest PC Past Accepting new patients
Healthcare Midwest PC Past Accepting new patients
Healthcare Midwest PC Past Accepting new patients

Organizations & group practices 8

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294358400000",
    "number": "1104866573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4613 W MAIN ST",
            "address_2": "SUITE C",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490062645",
            "telephone_number": "269-488-8360",
            "fax_number": "269-488-8359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4613 W MAIN ST",
            "address_2": "SUITE C",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490062645",
            "telephone_number": "269-488-8360",
            "fax_number": "269-488-8359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINZE",
        "first_name": "MARC",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "M.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2011-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501011803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "650C901900",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT LAKES HLTH PLAN",
            "identifier": "155812",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN",
            "identifier": "7173604",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2011; 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.