Individual provider Active NPI

Kyle Andrew Hamilton, KYLE HAMILTON, MSPT

  • Physical Therapist
  • Traverse City, MI
National Provider Identifier
1629290390
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501010501 Issued in MI
Practice address
5363 Gray Rd
Suite 25
Traverse City, MI 49684-8340
Phone
(231) 649-6446
NPI assigned
May 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 5501010501 MI Primary

Addresses

Primary practice location

5363 Gray Rd
Suite 25
Traverse City, MI 49684-8340

Mailing address

5363 Gray Rd Apt 25
Suite 25
Traverse City, MI 49684-8340
Phone (231) 649-6446

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071015000465 MI Practitioner - Physical Therapist in Private Practice 8729174255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5363 Gray Rd
Apt 25
Traverse City, MI 49684-8340
Phone (231) 352-0647

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501010501MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hamilton'S Home Therapy P.C. Physical Therapist CurrentSince Jul 23, 2007 Accepting new patients

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": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629290390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5363 GRAY RD APT 25",
            "address_2": "SUITE 25",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496848340",
            "telephone_number": "231-649-6446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5363 GRAY RD",
            "address_2": "SUITE 25",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496848340",
            "telephone_number": "231-649-6446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "KYLE",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "KYLE HAMILTON, MSPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501010501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.