Individual provider Active NPI

Jonathan Diep

  • Physical Therapist
  • Ypsilanti, MI
National Provider Identifier
1659899433
Registry record updated Aug 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1613 S Huron St
Ypsilanti, MI 48197-9701
Phone
(734) 483-9200
Fax
(734) 483-9202
NPI assigned
Aug 31, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501018390 MI
Physical Therapist 225100000X Primary

Addresses

Primary practice location

1613 S Huron St
Ypsilanti, MI 48197-9701

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170911000369 MI Practitioner - Physical Therapist in Private Practice 0941573109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michigan Rehabilitation Specialists of Fowlerville LLCGroup PAC ID 6204730393, 125 clinicians

Practice addresses (Care Compare)

1613 S Huron St
Ati Physical Therapy
Ypsilanti, MI 48197-9701
Phone (734) 483-9200

Merit-based Incentive Payment System (MIPS)

Final score
85.78 of 100Reported as group
Quality
89.5
Improvement activities
40
Cost
71.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501018390MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Rehabilitation Specialists of Fowlerville LLC Physical Therapist CurrentSince Aug 1, 2017 Accepting new patients
Michigan Rehabilitation Specialists of Fowlerville, LLC CurrentSince Aug 1, 2017 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

3157 Fairlane Dr
Allen Park, MI 48101
Phone (313) 827-0099

121 E Liberty St
Ann Arbor, MI 48104
Phone (734) 794-4619

2625 Plymouth Rd
Ann Arbor, MI 48105
Phone (734) 585-3313

5700 Jackson Rd
Ann Arbor, MI 48103
Phone (734) 926-4710

3500 Washtenaw Ave
Ste B
Ann Arbor, MI 48104
Phone (734) 794-9915

4765 Jackson Rd
Ste B
Ann Arbor, MI 48103
Phone (734) 926-4710

42955 Ford Rd
Canton, MI 48187
Phone (734) 981-2100

1110 S Main St
Chelsea, MI 48118
Phone (734) 593-3074

10078 Lapeer Rd
Ste B
Davison, MI 48423
Phone (810) 653-6200

7057 Dexter Ann Arbor Rd
Dexter, MI 48130
Phone (734) 426-1406

2810 Baker Rd
#101
Dexter, MI 48130
Phone (734) 424-9710

33566 W 8 Mile Rd
Ste A
Farmington Hills, MI 48335
Phone (248) 478-7330

1235 Holiday Blvd
Monroe, MI 48162
Phone (734) 242-4866

9604 Chilson Cmns
Pinckney, MI 48169

14349 Telegraph Rd
Redford, MI 48239
Phone (313) 541-2886

21308 Eureka Rd
Taylor, MI 48180
Phone (734) 759-0271

11650 Belleville Rd
Ste 102
Van Buren Township, MI 48111
Phone (734) 325-2443

5210 Highland Rd
Ste 100
Waterford, MI 48327
Phone (248) 674-9560

23309 Allen Rd
Woodhaven, MI 48183
Phone (734) 561-0070

1613 S Huron St
Ypsilanti, MI 48197
Phone (734) 483-9200

Organizations & group practices 2

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": "1504137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504137600000",
    "number": "1659899433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1613 S HURON ST",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481979701",
            "telephone_number": "734-483-9200",
            "fax_number": "734-483-9202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEP",
        "first_name": "JONATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-31",
        "last_updated": "2017-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501018390",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2017; 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.