Individual provider Active NPI

Brian Patrick Wolfe, PT, DPT

  • Physical Therapist
  • Southfield, MI
National Provider Identifier
1669782363
Registry record updated Apr 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501015389 Issued in MI
Practice address
26571 Evergreen Rd
Southfield, MI 48076-4201
Phone
(248) 639-4804
Fax
(248) 639-4805
NPI assigned
Oct 14, 2010
Last updated
Apr 2, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2019

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 5501015389 MI Primary

Addresses

Primary practice location

26571 Evergreen Rd
Southfield, MI 48076-4201

Mailing address

600 Oakmont LN Ste 600C
Westmont, IL 60559-5548
Phone (630) 575-6200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180403002587 MI Practitioner - Physical Therapist in Private Practice 5294097283 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Medical University of South Carolina College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

26571 Evergreen Rd
Southfield, MI 48076-4201
Phone (248) 639-4804

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Dec 1, 2019 Accepting new patients
St Mary Rehabilitation Services LLC Physical Therapist CurrentSince Apr 1, 2018 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Dec 1, 2019 Accepting new patients

Locations

600 Oakmont Ln
Ste 600C
Westmont, IL 60559
Phone (630) 575-6250

1801 W Maumee St
Ste 125
Adrian, MI 49221
Phone (517) 264-6141

2570 Jackson Ave
Ste C
Ann Arbor, MI 48103
Phone (734) 823-7820

1940 S Telegraph Rd
Bloomfield Hills, MI 48302
Phone (248) 409-0490

42621 Garfield Rd
Clinton Twp, MI 48038
Phone (586) 228-6688

42621 Garfield Rd
Ste 102
Clinton Twp, MI 48038
Phone (586) 838-2444

1485 N Michigan Ave
Ste 100
Howell, MI 48843
Phone (517) 545-5880

26571 Evergreen Rd
Southfield, MI 48076
Phone (248) 639-4804

3334 Rochester Rd
Troy, MI 48083
Phone (248) 953-2993

6585 Rochester Rd
Ste 102
Troy, MI 48085
Phone (833) 823-3300

Interoperability endpoints

  • Direct secure messaging: brian.wolfe.p4@direct.athleticoltd.nextgenshare.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1287014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554163200000",
    "number": "1669782363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 OAKMONT LN STE 600C",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595548",
            "telephone_number": "630-575-6200",
            "fax_number": "630-928-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26571 EVERGREEN RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480764201",
            "telephone_number": "248-639-4804",
            "fax_number": "248-639-4805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFE",
        "first_name": "BRIAN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-14",
        "last_updated": "2019-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501015389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2019; 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.