Individual provider Active NPI

Thirumal Reddy Vanteru, PT

  • Physical Therapist
  • Grand Rapids, MI
National Provider Identifier
1184741761
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501013067 Issued in MI
Practice address
1111 Leffingwell Ave NE
Grand Rapids, MI 49525-6406
Phone
(616) 459-7101
Fax
(616) 464-6170
NPI assigned
Mar 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501013067 MI Primary
Contractor 171W00000X 5501013067 MI

Addresses

Primary practice location

1111 Leffingwell Ave NE
Grand Rapids, MI 49525-6406

Mailing address

1111 Leffingwell Ave NE Ste 201
Grand Rapids, MI 49525-6406
Phone (616) 459-7101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1111 Leffingwell Ave NE
Grand Rapids, MI 49525-6406

Merit-based Incentive Payment System (MIPS)

Final score
78.51 of 100Reported as group
Quality
49.04
Promoting interoperability
96
Improvement activities
40
Cost
82.67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501013067MIMDContractor

Practice roles

OrganizationSpecialtyStatusNew patients
Access Therapies at Home Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: thirumal.vanteru.p1@direct.oam.nextgenshare.com

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, 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": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1184741761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 LEFFINGWELL AVE NE STE 201",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256406",
            "telephone_number": "616-459-7101",
            "fax_number": "616-464-6170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 LEFFINGWELL AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256406",
            "telephone_number": "616-459-7101",
            "fax_number": "616-464-6170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANTERU",
        "first_name": "THIRUMAL",
        "middle_name": "REDDY",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501013067",
            "primary": true
        },
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "MI",
            "license": "5501013067",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.