Individual provider Active NPI

Jack Berkey, DPT

  • Physical Therapist
  • West Bloomfield, MI
National Provider Identifier
1477393379
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501303315 Issued in MI
Practice address
4312 Orchard Lake Rd
West Bloomfield, MI 48323-1637
Phone
(248) 788-6100
NPI assigned
May 29, 2024
Last updated
May 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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 5501303315 MI Primary

Addresses

Primary practice location

4312 Orchard Lake Rd
West Bloomfield, MI 48323-1637

Mailing address

1773 Star Batt Dr
Rochester Hills, MI 48309-3708
Phone (248) 601-9207

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240621001355 MI Practitioner - Physical Therapist in Private Practice 1153864970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
VMS of Macomb TWP LLCGroup PAC ID 7012072952, 22 clinicians

Practice addresses (Care Compare)

4312 Orchard Lake Rd
Suite 100
West Bloomfield, MI 48323-1637
Phone (248) 788-6100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
HQ of West Bloomfield LLC Physical Therapist CurrentSince Jun 1, 2024 Accepting new patients
VMS of Macomb TWP LLC CurrentSince Jun 1, 2024 Accepting new patients
Trishard P.C. Past Accepting new patients

Locations

22573 Hall Rd
Macomb, MI 48042
Phone (586) 231-0043

1773 Star Batt Dr
Rochester Hills, MI 48309
Phone (248) 650-4720

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1716940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1477393379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1773 STAR BATT DR",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483093708",
            "telephone_number": "248-601-9207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4312 ORCHARD LAKE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483231637",
            "telephone_number": "248-788-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERKEY",
        "first_name": "JACK",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-29",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501303315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; 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.