Individual provider Active NPI

David Clark Krombeen, DPT

  • Physical Therapist
  • Grandville, MI
National Provider Identifier
1396119228
Registry record updated Mar 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501017487 Issued in MI
Practice address
4120 Chicago Dr SW
Grandville, MI 49418-1281
Phone
(616) 534-0366
Fax
(616) 534-0540
NPI assigned
Nov 16, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2016

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 5501017487 MI Primary

Addresses

Primary practice location

4120 Chicago Dr SW
Grandville, MI 49418-1281

Mailing address

1331 Lake Dr SE
Ste 105
Grand Rapids, MI 49506-1674
Phone (616) 534-0366

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160307001898 MI Practitioner - Physical Therapist in Private Practice 7810293545 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michigan Ear Nose Throat and Allergy Specialists PCGroup PAC ID 4183868094, 42 clinicians

Practice addresses (Care Compare)

3100 N Wellness Dr
Holland, MI 49424-8122
Phone (616) 994-2770

Merit-based Incentive Payment System (MIPS)

Final score
85.85 of 100Reported as group
Quality
81.22
Promoting interoperability
100
Improvement activities
40
Cost
71.61

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501017487MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Ear, Nose, Throat, and Allergy Specialists, PC Physical Therapist CurrentSince Jan 15, 2018 Accepting new patients
Progressive Physical Therapy PLC Physical Therapist Past Accepting new patients

Locations

11160 Wj Presley Pkwy
Ste 103
Allendale, MI 49401
Phone (616) 895-4050

3501 Rivertown Point Ct SW
Grandville, MI 49418
Phone (616) 396-1433

3100 N Wellness Dr
Holland, MI 49424
Phone (616) 396-1433

Organizations & group practices 2

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": "1447632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456790400000",
    "number": "1396119228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 LAKE DR SE",
            "address_2": "STE 105",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495061674",
            "telephone_number": "616-534-0366",
            "fax_number": "616-534-0540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4120 CHICAGO DR SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494181281",
            "telephone_number": "616-534-0366",
            "fax_number": "616-534-0540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROMBEEN",
        "first_name": "DAVID",
        "middle_name": "CLARK",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-16",
        "last_updated": "2016-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501017487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grandville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2016; 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.