Individual provider Active NPI

Brian P Poirier, M.P.T.

  • Physical Therapist
  • Dubuque, IA
National Provider Identifier
1386861284
Registry record updated Jun 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
03638 Issued in IA
Practice address
1500 Associates Dr
Dubuque, IA 52002-2201
Phone
(563) 584-4465
Fax
(563) 584-4395
NPI assigned
Apr 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2008

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 03638 IA Primary

Addresses

Primary practice location

1500 Associates Dr
Dubuque, IA 52002-2201

Mailing address

1500 Associates Dr
Dubuque, IA 52002-2201
Phone (563) 584-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, WI, IL3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20080624000776 IA Practitioner - Physical Therapist in Private Practice 6800967506 Reassigns benefits to 1 organization
I20080829000553 WI Practitioner - Physical Therapist in Private Practice 6800967506 Reassigns benefits to 1 organization
I20090415000511 IL Practitioner - Physical Therapist in Private Practice 6800967506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Associates Clinic P CGroup PAC ID 3870491228, 228 clinicians

Practice addresses (Care Compare)

10988 Bartel Blvd
Galena, IL 61036-8222
Phone (815) 777-0900

1240 Big Jack Rd
Platteville, WI 53818-8902
Phone (608) 348-6266

1500 Associates Dr
Dubuque, IA 52002-2201
Phone (563) 584-4100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
03638IAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates Clinic P C CurrentSince Jun 2, 2008 Accepting new patients

Locations

1500 Associates Dr
Dubuque, IA 52002
Phone (563) 584-4100

1000 Langworthy St
Dubuque, IA 52001
Phone (563) 584-3455

10988 Bartel Blvd
Galena, IL 61036
Phone (815) 777-0900

1240 Big Jack Rd
Platteville, WI 53818
Phone (608) 348-2844

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": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212364800000",
    "number": "1386861284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 ASSOCIATES DR",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520022201",
            "telephone_number": "563-584-4100",
            "fax_number": "563-584-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 ASSOCIATES DR",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520022201",
            "telephone_number": "563-584-4465",
            "fax_number": "563-584-4395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POIRIER",
        "first_name": "BRIAN",
        "middle_name": "P",
        "credential": "M.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-20",
        "last_updated": "2008-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "03638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; 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.