Individual provider Active NPI

Jacob Young, DPT

  • Physical Therapist
  • Bridgeport, MI
National Provider Identifier
1699152645
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
5460 W Rolling Hills Dr
Bridgeport, MI 48722-9668
Phone
(989) 272-4500
NPI assigned
Apr 29, 2015
Last updated
Oct 9, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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 Primary

Addresses

Primary practice location

5460 W Rolling Hills Dr
Bridgeport, MI 48722-9668

Mailing address

5620 Bloomfield Dr
Midland, MI 48642-3272
Phone (734) 652-7777

Other practice location 1

324 S Saginaw Rd
Midland, MI 48640-4500
Phone (989) 631-3570

Other identifiers 1

IdentifierTypeStateIssuer
5501017310OtherMISTATE LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210908001282 MI Practitioner - Physical Therapist in Private Practice 9133525777 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renue 012 Essexville LLCGroup PAC ID 7618211236, 9 clinicians
Renue 004 Bridgeport LLCGroup PAC ID 4183850266, 11 clinicians

Practice addresses (Care Compare)

2618 Ctr Ave
Bay City, MI 48708-6300
Phone (989) 450-3341

4760 Garfield Rd
Suite B
Auburn, MI 48611-9434
Phone (989) 662-8855

5460 W Rolling Hills Dr
Bridgeport, MI 48722-9668
Phone (989) 272-4500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Renue 009 Midland LLC Physical Therapist CurrentSince Oct 23, 2023 Accepting new patients
Benchmark Physical Therapy Michigan LLC Physical Therapist CurrentSince Apr 1, 2022 Accepting new patients
Renue 018 Tawas, LLC Physical Therapist CurrentSince Nov 18, 2024 Accepting new patients
Renue 006 Saginaw State St LLC Physical Therapist CurrentSince Oct 23, 2023 Accepting new patients
Renue 002 Bay City LLC Physical Therapist CurrentSince Oct 23, 2023 Accepting new patients
Renue 001 Freeland LLC Physical Therapist CurrentSince Oct 23, 2023 Accepting new patients
Renue 004 Bridgeport, LLC Physical Therapist CurrentSince Oct 23, 2023 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

401 E Huron Rd
Au Gres, MI 48703
Phone (989) 254-6360

3720 Katalin Ct
Ste 202
Bay City, MI 48706
Phone (989) 941-3007

3720 Wilder Rd
Ste D
Bay City, MI 48706
Phone (989) 402-1215

804 N Water St
Bay City, MI 48708
Phone (989) 450-3341

5460 W Rolling Hills Dr
Bridgeport, MI 48722
Phone (989) 272-4500

4823 N Coleman Schools Dr
Coleman, MI 48618
Phone (866) 625-3570

406 W Genesee St
Ste B
Frankenmuth, MI 48734
Phone (866) 625-3570

7329 Industrial Dr
Freeland, MI 48623
Phone (989) 573-8266

2520 W Wackerly St
Midland, MI 48640
Phone (989) 423-1240

324 S Saginaw Rd
Midland, MI 48640
Phone (989) 631-3570

555 W Wackerly St
Ste 3600
Midland, MI 48640
Phone (989) 631-3570

715 E Main St
Midland, MI 48640
Phone (989) 374-2222

4431 N US Highway 23
Oscoda, MI 48750
Phone (989) 254-6455

1915 Fordney St
Saginaw, MI 48601
Phone (989) 355-1010

4616 State St
Saginaw, MI 48603
Phone (989) 355-1010

8680 Gratiot Rd
Ste B
Saginaw, MI 48609
Phone (989) 401-4791

540 W Lake St
Ste 3
Tawas City, MI 48763
Phone (989) 984-6075

Organizations & group practices 9

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": "1430265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1699152645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5620 BLOOMFIELD DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486423272",
            "telephone_number": "734-652-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5460 W ROLLING HILLS DR",
            "city": "BRIDGEPORT",
            "state": "MI",
            "postal_code": "487229668",
            "telephone_number": "989-272-4500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "324 S Saginaw Rd",
            "address_purpose": "LOCATION",
            "city": "Midland",
            "state": "MI",
            "postal_code": "486404500",
            "country_code": "US",
            "telephone_number": "989-631-3570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JACOB",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-29",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "5501017310",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; 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.