NPIMap

Organization Active NPI

Upper Peninsula Rehabilitation Medicine Associates P.C.

Doing business as U P Rehabilitation Medicine Associates PC

  • Physical Medicine & Rehabilitation Physician
  • Marquette, MI
National Provider Identifier
1659468064
Registry record updated Jul 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
UPPER PENINSULA REHABILITATION MEDICINE ASSOCIATES P.C.
Doing business as
U P Rehabilitation Medicine Associates PC
Practice address
580 West Baraga Avenue Suite 30
Marquette, MI 49855
Phone
(906) 225-3914
Fax
(906) 225-4583
NPI assigned
Oct 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2019

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

Authorized official

Name
Louis Ostola, MDNPI 1205114832
Title
President
Phone
(906) 225-3914

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 Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

580 West Baraga Avenue Suite 30
Marquette, MI 49855

Mailing address

580 West Baraga Avenue Suite 30
Marquette, MI 49855
Phone (906) 225-3914

Other identifiers 1

IdentifierTypeStateIssuer
250E26047OtherMIBLUE CROSS BLUE SHIELD MI

Other names 1

  • U P Rehabilitation Medicine Associates PC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050802000217 MI Part B Supplier - Clinic/Group Practice 6608804505 Receives reassigned benefits from 9 practitioners
Practice locations: Marquette, MI

National Provider Directory

National Provider Directory

Locations

2833 US Highway 41 W
Marquette, MI 49855

850 W Baraga Ave
Ste 30
Marquette, MI 49855
Phone (906) 225-3914

580 W College Ave
Ste 119
Marquette, MI 49855
Phone (906) 225-3914

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564531200000",
    "number": "1659468064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 WEST BARAGA AVENUE SUITE 30",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "49855",
            "telephone_number": "906-225-3914",
            "fax_number": "906-225-4583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 WEST BARAGA AVENUE SUITE 30",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "49855",
            "telephone_number": "906-225-3914",
            "fax_number": "906-225-4583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPPER PENINSULA REHABILITATION MEDICINE ASSOCIATES P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2019-07-31",
        "status": "A",
        "authorized_official_last_name": "OSTOLA",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "906-225-3914",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MI",
            "identifier": "250E26047",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "U P Rehabilitation Medicine Associates PC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "U P Rehabilitation Medicine Associates PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marquette, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2019; 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.