Timothy Daniel Vincent, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501008034 Issued in MI

Practice address

7609 Brockway Rd
Brockway, MI 48097-3459

Phone

(810) 387-4900

Fax

(810) 387-9200

NPI assigned

Oct 30, 2006

Last updated

Jan 5, 2022By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prostaff Physical Therapy, PLLCGroup PAC ID 2264452283, 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Prostaff Physical Therapy, PLLC

  • Physical Therapy Clinic/Center
  • Brockway, MI
  • NPI 1598966764

  Physical Therapist

  Medicare reassignment Care Compare group NPD Authorized official
• Lexington Physical Therapy PLLC

  • Physical Therapist
  • Lexington, MI
  • NPI 1689347254
  NPD (past)

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

{
    "created_epoch": "1162166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1679659924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7609 BROCKWAY RD",
            "city": "BROCKWAY",
            "state": "MI",
            "postal_code": "480973459",
            "telephone_number": "810-387-4900",
            "fax_number": "810-359-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7609 BROCKWAY RD",
            "city": "BROCKWAY",
            "state": "MI",
            "postal_code": "480973459",
            "telephone_number": "810-387-4900",
            "fax_number": "810-387-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "TIMOTHY",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-30",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501008034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tim@prostaffphysicaltherapy.com",
            "affiliation": "N",
            "endpointDescription": "Physical therapy",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Yale",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "Physical therapy",
            "address_1": "7609 Brockway Rd",
            "city": "Brockway",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480973459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Renee Ruiz, CPNP
• Katrina Louise Stachowiak, PA-C
• Brianna J Steadman, PA-C
• Tara Lynn Touchette, RN
• Laurel Dawn Vance
• Yale Dental Care

• Physical Therapist in Brockway, MI
• Providers in Brockway, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; 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.