Active NPI
Cory D Rogotzke, DPT
- Physical Therapist
- Jackson, MI
National Provider Identifier
1154768463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501016325
- Practice address
- 2136 Robinson Rd Ste 1
Jackson, MI 49203-3558 - Phone
- (517) 750-2540
- Fax
- (517) 990-6212
- NPI assigned
- May 28, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501016325 | MI | Primary |
Addresses
Primary practice location
2136 Robinson Rd Ste 1
Jackson, MI 49203-3558
Mailing address
3073 Shirley Dr
Jackson, MI 49201-7010
Phone (517) 990-6211
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0C80228 | Other | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2136 Robinson Rd
Suite 1
Jackson, MI 49203-3558
Phone (517) 750-2540
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Organizations & group practices 1
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.
-
- Physical Therapist
- Jackson, MI
- NPI 1619956646
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739145600000",
"number": "1154768463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3073 SHIRLEY DR",
"city": "JACKSON",
"state": "MI",
"postal_code": "492017010",
"telephone_number": "517-990-6211",
"fax_number": "517-990-6212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2136 ROBINSON RD STE 1",
"city": "JACKSON",
"state": "MI",
"postal_code": "492033558",
"telephone_number": "517-750-2540",
"fax_number": "517-990-6212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROGOTZKE",
"first_name": "CORY",
"middle_name": "D",
"name_prefix": "Mr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-05-28",
"last_updated": "2025-02-10",
"certification_date": "2025-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501016325",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "0C80228",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.