Individual provider Active NPI

Nicholas Ryan Mason, DPT

  • Physical Therapist
  • Greenville, MI
National Provider Identifier
1124428362
Registry record updated Aug 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501016902 Issued in MI
Practice address
1330 W Washington St
Greenville, MI 48838-2190
Phone
(616) 754-7040
Fax
(616) 754-7888
NPI assigned
Aug 25, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2014

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 5501016902 MI Primary

Addresses

Primary practice location

1330 W Washington St
Greenville, MI 48838-2190

Mailing address

1330 W Washington St
Greenville, MI 48838-2190
Phone (616) 754-7040

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210224001700 MI Practitioner - Physical Therapist in Private Practice 6709291735 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advent Rehabilitation, LLCGroup PAC ID 9537070545, 57 clinicians

Practice addresses (Care Compare)

150 Jefferson Ave SE
Suite 100
Grand Rapids, MI 49503-4306
Phone (616) 284-3690

3686 32ND Ave
Suite 400
Hudsonville, MI 49426-8546
Phone (616) 377-1010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Physical Therapy Group LLC Physical Therapist CurrentSince Mar 15, 2021 Accepting new patients
Advent Rehabilitation, LLC Physical Therapist CurrentSince May 17, 2021 Accepting new patients
Advent Rehabilitation, LLC Physical Therapist CurrentSince May 17, 2021 Accepting new patients

Locations

6745 Fulton St E
Ste D
Ada, MI 49301
Phone (616) 274-1014

150 Jefferson Ave SE
Ste 100
Grand Rapids, MI 49503
Phone (616) 284-3690

607 Dewey Ave NW
Ste 300
Grand Rapids, MI 49504
Phone (253) 332-3398

601 Michigan Ave
Ste 220
Holland, MI 49423
Phone (616) 355-4284

24466 Red Arrow Hwy
Ste D
Mattawan, MI 49071
Phone (269) 359-7353

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": "1408924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408924800000",
    "number": "1124428362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 W WASHINGTON ST",
            "city": "GREENVILLE",
            "state": "MI",
            "postal_code": "488382190",
            "telephone_number": "616-754-7040",
            "fax_number": "616-754-7888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 W WASHINGTON ST",
            "city": "GREENVILLE",
            "state": "MI",
            "postal_code": "488382190",
            "telephone_number": "616-754-7040",
            "fax_number": "616-754-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "NICHOLAS",
        "middle_name": "RYAN",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-25",
        "last_updated": "2014-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501016902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2014; 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.