Gerald Joseph Kozak III, MPT
Individual provider Active NPI Physical Therapist · Almont, MI
NPI 1780720250 · NPPES record last updated Oct 24, 2023
Key facts
- NPI
- 1780720250
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 5501012904 (MI)
- Practice address
- 122 S Main St
Almont, MI 48003-1066 - Phone
- (800) 974-4378
- Fax
- (630) 515-1536
- NPI assigned
- Jan 30, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- DPT Holdings LLC
Practice addresses (Care Compare)
122 S Main St
Almont, MI 48003-1066
Phone (800) 974-4378
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231025003728 | MI | Practitioner - Physical Therapist in Private Practice | 7113373218 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L951582 | MI | MD | Orthopedic Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DPT Holdings PLLC | Physical Therapist | Current |
Accepting new patients |
| Henry Ford Health Macomb-Oakland Hospital | Past | Accepting new patients |
Locations
24014 W Renwick Rd
Ste 206
Plainfield, IL 60544
1235 S Center Rd
Burton, MI 48509
Phone (800) 977-4378
1842 Demille Rd
Lapeer, MI 48446
Phone (810) 667-1962
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | L951582 | MI | |
| Physical Therapist | 225100000X | 5501012904 | MI | Yes |
Addresses
Primary practice location
122 S Main St
Almont, MI 48003-1066
Mailing address
24014 W Renwick Rd Unit 206
Plainfield, IL 60544-8711
Phone (800) 974-4378
Other names
- Gerry Kozak
Other providers in Almont, MI
- Julie Johnson
- Jolly Joseph
- Kamego Chiropractic Clinic L.C.
- Gregory Joseph Kamego
- Judith Ann Koskodan
- Tami Kozlowski
- Lane Swayze Clinic, P.C.
- Rachel Lauwers
- Lois E. Meek, D.D.S., P.C.
- James D McCarley
All providers in Almont, MI · Physical Therapist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.