Individual provider Active NPI

Timothy Olthoff, DPT

  • Physical Therapist
  • Grand Rapids, MI
National Provider Identifier
1679022115
Registry record updated Sep 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501017892 Issued in MI
Practice address
3826 44TH St SE
Grand Rapids, MI 49512-3919
Phone
(616) 554-0918
NPI assigned
Sep 26, 2016
Last updated
Sep 26, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2016

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 5501017892 MI Primary

Addresses

Primary practice location

3826 44TH St SE
Grand Rapids, MI 49512-3919

Mailing address

3826 44TH St SE
Grand Rapids, MI 49512-3919
Phone (616) 554-0918

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161021000064 MI Practitioner - Physical Therapist in Private Practice 1254619505 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Motion Physical Therapy Services IncGroup PAC ID 4981679743, 3 clinicians

Practice addresses (Care Compare)

3826 44TH St SE
Kentwood, MI 49512-3919
Phone (616) 554-0918

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Health Motion Physical Therapy Services Inc Physical Therapist CurrentSince Sep 30, 2016 Accepting new patients

Locations

3826 44th St SE
Kentwood, MI 49512
Phone (616) 451-4284

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, 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": "1474848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474848000000",
    "number": "1679022115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3826 44TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495123919",
            "telephone_number": "616-554-0918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3826 44TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495123919",
            "telephone_number": "616-554-0918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLTHOFF",
        "first_name": "TIMOTHY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-26",
        "last_updated": "2016-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501017892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.