Jonathan Sison Del Rosario, PT
Individual provider Active NPI Physical Therapist · Croswell, MI
NPI 1245389352 · NPPES record last updated Jun 27, 2008
Key facts
- NPI
- 1245389352
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 5501007571 (MI)
- Practice address
- 51 Brown St Ste 5
Croswell, MI 48422-1159 - Phone
- (810) 679-0078
- Fax
- (810) 679-4678
- NPI assigned
- Jan 9, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
4990 N Van Dyke Rd
Athletic and Manual Therapy
Kinde, MI 48445-9617
Phone (989) 874-4600
51 Brown St
Suite 5
Croswell, MI 48422-1159
Phone (810) 679-0078
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040910001288 | MI | Practitioner - Physical Therapist in Private Practice | 5890762736 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Croswell Manual Therapy, Inc | Physical Therapist | Current |
Accepting new patients |
| Croswell Manual Therapy Inc. | Physical Therapist | Current |
Accepting new patients |
Locations
51 Brown St
Ste 5
Croswell, MI 48422
Phone (810) 679-0078
119 State St
Harbor Beach, MI 48441
Phone (989) 479-0621
4990 N Van Dyke Rd
Kinde, MI 48445
Phone (989) 874-4600
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501007571 | MI | Yes |
Addresses
Primary practice location
51 Brown St Ste 5
Croswell, MI 48422-1159
Mailing address
302 N Port Crescent St
Bad Axe, MI 48413-1222
Phone (989) 269-3045
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 650G610300 | Other | MI | BCBS |
| 0N97200 | Other | MEDICARE ID |
Other providers in Croswell, MI
- Croswell Manual Therapy Inc.
- Kimberley A Curell
- Valyn Quinn Cutcher
- John Dawson
- Cristina De Gregory
- Ehardt'S Advanced Care Pharmacy & Medical Supplies
- Ehardt'S Pharmacy Inc
- Raymond J Emond
- Carissa Fenner
- Maija Matintytar Fenner
All providers in Croswell, MI · Physical Therapist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 27, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.