Individual provider Active NPI

Brent Cheyne, DPT

  • Physical Therapist
  • Plymouth, MI
National Provider Identifier
1275239204
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501302027 Issued in MI
Practice address
47635 Five Mile Rd
Plymouth, MI 48170-2418
Phone
(734) 489-6254
Fax
(734) 418-7356
NPI assigned
Feb 1, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

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 5501302027 MI Primary

Addresses

Primary practice location

47635 Five Mile Rd
Plymouth, MI 48170-2418

Mailing address

1311 Mamaroneck Ave Ste 140
White Plains, NY 10605-5224

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230206001732 MI Practitioner - Physical Therapist in Private Practice 1052783735 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab Michigan LLCGroup PAC ID 6901165893, 156 clinicians

Practice addresses (Care Compare)

47635 Five Mile Rd
Plymouth, MI 48170-2418
Phone (734) 489-6254

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501302027MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Michigan, LLC Physical Therapist CurrentSince Feb 2, 2023 Accepting new patients

Locations

135 S Milford Rd
Ste 307
Milford, MI 48381

135 S Milford Rd
Milford, MI 48381
Phone (248) 685-7272

2085 W Grand River Ave
Ste C
Okemos, MI 48864
Phone (517) 246-2626

1764 S Ortonville Rd
Ortonville, MI 48462
Phone (248) 793-5730

1764 S Ortonville Rd
Ste 400
Ortonville, MI 48462
Phone (248) 793-5730

47635 Five Mile Rd
Plymouth, MI 48170
Phone (734) 489-6254

1311 Mamaroneck Ave
Ste 140
White Plains, NY 10605
Phone (914) 265-4838

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1675209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1275239204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47635 FIVE MILE RD",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481702418",
            "telephone_number": "734-489-6254",
            "fax_number": "734-418-7356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEYNE",
        "first_name": "BRENT",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-01",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501302027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; 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.