Organization Active NPI

Oosthoek Physical Therapy PC

  • Orthopedic Physical Therapist
  • Dearborn, MI
National Provider Identifier
1740945443
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Legal business name
OOSTHOEK PHYSICAL THERAPY PC
Practice address
24530 Michigan Ave
Dearborn, MI 48124-1711
Phone
(313) 759-0777
Fax
(313) 749-7882
NPI assigned
Nov 8, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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

Authorized official

Name
Kornelis Oosthoek, PTNPI 1770671299
Title
President
Phone
(248) 318-0026

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251X0800X Primary

Addresses

Primary practice location

24530 Michigan Ave
Dearborn, MI 48124-1711

Mailing address

1247 Castlewood Dr
White Lake, MI 48386-3720
Phone (248) 318-0026

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211129002283 MI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5597155929 Receives reassigned benefits from 2 practitioners
Practice locations: Canton, MI; Dearborn, MI; White Lake, MI

National Provider Directory

National Provider Directory

Locations

6200 N Haggerty Rd
Ste 500
Canton, MI 48187
Phone (734) 215-2434

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1636329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636329600000",
    "number": "1740945443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1247 CASTLEWOOD DR",
            "city": "WHITE LAKE",
            "state": "MI",
            "postal_code": "483863720",
            "telephone_number": "248-318-0026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24530 MICHIGAN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241711",
            "telephone_number": "313-759-0777",
            "fax_number": "313-749-7882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OOSTHOEK PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-08",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A",
        "authorized_official_last_name": "OOSTHOEK",
        "authorized_official_first_name": "KORNELIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-318-0026",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.