Individual provider Active NPI

Jukka Olavi Pietila, PT

  • Physical Therapist
  • Grand Rapids, MI
National Provider Identifier
1245274547
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501006211 Issued in MI
Practice address
4085 Burton St SE Ste 100
Grand Rapids, MI 49546-2444
Phone
(616) 233-3599
NPI assigned
Jun 16, 2006
Last updated
Jan 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 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 5501006211 MI Primary

Addresses

Primary practice location

4085 Burton St SE Ste 100
Grand Rapids, MI 49546-2444

Mailing address

61 Commerce Ave SW
Grand Rapids, MI 49503-4124
Phone (616) 940-0660

Other identifiers 1

IdentifierTypeStateIssuer
650D115990OtherMIBCBSM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060725000146 MI Practitioner - Physical Therapist in Private Practice 5890708572 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1990
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)

4085 Burton St SE
Suite 100
Grand Rapids, MI 49546-2444
Phone (616) 233-3599

Merit-based Incentive Payment System (MIPS)

Final score
81.38 of 100Reported as group
Quality
70.13
Promoting interoperability
100
Improvement activities
40
Cost
67.82

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ompt Specialists, Inc. Physical Therapist CurrentSince Nov 8, 2021 Accepting new patients
Advent Rehabilitation, LLC Physical Therapist CurrentSince Jan 20, 2025 Accepting new patients
Advent Rehabilitation, LLC Physical Therapist CurrentSince Jan 20, 2025 Accepting new patients

Locations

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

245 Cherry St SE
Ste 102
Grand Rapids, MI 49503
Phone (616) 201-3909

4085 Burton St SE
Ste 100
Grand Rapids, MI 49546
Phone (616) 233-3599

399 Oaks Xing
Plainwell, MI 49080
Phone (269) 222-5400

1080 Kirts Blvd
Ste 300
Troy, MI 48084

4600 Investment Dr
Ste 190
Troy, MI 48098
Phone (242) 353-1234

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, 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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1245274547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 COMMERCE AVE SW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034124",
            "telephone_number": "616-940-0660",
            "fax_number": "616-940-1965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4085 BURTON ST SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462444",
            "telephone_number": "616-233-3599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIETILA",
        "first_name": "JUKKA",
        "middle_name": "OLAVI",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501006211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "650D115990",
            "state": "MI"
        }
    ],
    "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 Jan 21, 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.