Individual provider Active NPI

Cooper Cyr

  • Physical Therapist
  • Suffolk, VA
National Provider Identifier
1285378174
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305217370 Issued in VA
Practice address
1033 Champions Way
Suffolk, VA 23435-3777
Phone
(757) 372-9953
Fax
(757) 372-9954
NPI assigned
Apr 26, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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 2305217370 VA Primary
Physical Therapist 225100000X 26141 MA

Addresses

Primary practice location

1033 Champions Way
Suffolk, VA 23435-3777

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-6200

Other practice location 1

84 Highland Ave Ste 201
Salem, MA 01970-2736
Phone (978) 741-0880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220609002710 MA Practitioner - Physical Therapist in Private Practice 5395123954 Reassigns benefits to 1 organization
I20251217000561 VA Practitioner - Physical Therapist in Private Practice 5395123954 Reassigns benefits to 3 organizations

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
Tidewater Physical Therapy LLCGroup PAC ID 6406759281, 225 clinicians
Proex Physical Therapy LLCGroup PAC ID 0345212395, 166 clinicians

Practice addresses (Care Compare)

1033 Champions Way
Suite 500
Suffolk, VA 23435-3775
Phone (757) 372-9953

84 Highland Ave
Suite 201
Salem, MA 01970-2736
Phone (978) 741-0880

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305217370VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Sep 29, 2025 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Sep 29, 2025 Accepting new patients
Proex Physical Therapy, LLC Physical Therapist CurrentSince May 26, 2022 Accepting new patients
Athletico, LTD Physical Therapist CurrentSince Sep 29, 2025 Accepting new patients
Professional Sportscare & Rehab, LLC Physical Therapist CurrentSince Sep 29, 2025 Accepting new patients
Proex Physical Therapy, LLC CurrentSince May 26, 2022 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Sep 29, 2025 Accepting new patients
Professional Sportscare & Rehab, LLC Physical Therapist Past Accepting new patients

Locations

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

10 High St
Ste 303
Boston, MA 02110
Phone (617) 542-6999

84 Highland Ave
Ste 201
Salem, MA 01970
Phone (978) 741-0880

576 Broadhollow Rd
Melville, NY 11747

10128 W Broad St
Bldg Iii
Glen Allen, VA 23060
Phone (804) 217-9210

11662 Sudley Manor Dr
#50B
Manassas, VA 20109
Phone (571) 321-5720

1033 Champions Way
Ste 500
Suffolk, VA 23435
Phone (757) 372-9953

4625 Virginia Beach Blvd
Ste 103
Virginia Beach, VA 23462
Phone (757) 600-5999

Organizations & group practices 8

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": "1650931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1285378174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-6200",
            "fax_number": "410-648-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 CHAMPIONS WAY",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353777",
            "telephone_number": "757-372-9953",
            "fax_number": "757-372-9954"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "84 Highland Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "MA",
            "postal_code": "019702736",
            "country_code": "US",
            "telephone_number": "978-741-0880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CYR",
        "first_name": "COOPER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-26",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305217370",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "26141",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.