NPIMap

Organization Active NPI

Shoreline Sport & Spine PLLC

  • Physical Therapist
  • Muskegon, MI
National Provider Identifier
1619787959
Registry record updated Dec 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SHORELINE SPORT & SPINE PLLC
Practice address
2073 Holton Rd
Muskegon, MI 49445-1535
Phone
(231) 744-0077
Fax
(616) 847-1290
NPI assigned
Jan 9, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Martin J SytsemaNPI 1447289277
Title
Ceo
Phone
(616) 847-1280

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

2073 Holton Rd
Muskegon, MI 49445-1535

Mailing address

18000 Cove St Ste 202
Spring Lake, MI 49456-1383
Phone (616) 847-1280

Other names 1

  • i'move Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260318003213 MI DME Supplier - Independently-Practicing Occupational Therapist 4284673575 Practice locations: Muskegon, MI

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
I'Move3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

17001 Ferris St
Grand Haven, MI 49417
Phone (616) 847-1280

65 S Main St
Ste C
Rockford, MI 49341
Phone (616) 866-8084

Practitioners & affiliated clinicians

Practitioners 52

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 52

NPI Registry JSON

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

{
    "created_epoch": "1736380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765497600000",
    "number": "1619787959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18000 COVE ST STE 202",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494561383",
            "telephone_number": "616-847-1280",
            "fax_number": "616-847-1290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2073 HOLTON RD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494451535",
            "telephone_number": "231-744-0077",
            "fax_number": "616-847-1290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORELINE SPORT & SPINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-09",
        "last_updated": "2025-12-12",
        "certification_date": "2025-12-12",
        "status": "A",
        "authorized_official_last_name": "SYTSEMA",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "616-847-1280"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "i'move",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Muskegon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.