Paul Bracket, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501008854 Issued in MI

Practice address

2001 Minneapolis Ave Ste C
Gladstone, MI 49837-2060

Phone

(906) 428-3085

Fax

(906) 428-3086

NPI assigned

May 17, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwoods Rehabilitation Inc.Group PAC ID 0941248843, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Northwoods Rehabilitation Inc.

  • Physical Therapy Clinic/Center
  • Gladstone, MI
  • NPI 1437273877

  MI, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Northwoods Rehabilitation Inc.

  • Physical Therapy Clinic/Center
  • Escanaba, MI
  • NPI 1023132461
  NPD (past)

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

{
    "created_epoch": "1463443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463443200000",
    "number": "1649627985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 MINNEAPOLIS AVE STE C",
            "city": "GLADSTONE",
            "state": "MI",
            "postal_code": "498372060",
            "telephone_number": "906-428-3085",
            "fax_number": "906-428-3086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 MINNEAPOLIS AVE STE C",
            "city": "GLADSTONE",
            "state": "MI",
            "postal_code": "498372060",
            "telephone_number": "906-428-3085",
            "fax_number": "906-428-3086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACKET",
        "first_name": "PAUL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-17",
        "last_updated": "2016-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501008854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dickinson County Healthcare System

• All providers in Gladstone, MI
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.