Individual provider Active NPI

Kyle Zwarych, DPT

  • Physical Therapist
  • Grand Rapids, MI
National Provider Identifier
1821712308
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501302166 Issued in MI
Practice address
1471 E Beltline Ave NE Ste 104
Grand Rapids, MI 49525-4548
Phone
(616) 577-8336
NPI assigned
Sep 28, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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 5501302166 MI Primary

Addresses

Primary practice location

1471 E Beltline Ave NE Ste 104
Grand Rapids, MI 49525-4548

Mailing address

625 Kenmoor Ave SE Ste 100
Grand Rapids, MI 49546-2395

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221010001559 MI Practitioner - Physical Therapist in Private Practice 6709262017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advent Rehabilitation, LLCGroup PAC ID 9537070545, 57 clinicians

Practice addresses (Care Compare)

1471 E Beltline Ave NE
Suite 104
Grand Rapids, MI 49525-4548
Phone (616) 233-3596

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501302166MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advent Rehabilitation, LLC Physical Therapist CurrentSince Oct 10, 2022 Accepting new patients
Advent Rehabilitation, LLC Physical Therapist CurrentSince Oct 10, 2022 Accepting new patients

Locations

6745 Fulton St E
Ste D
Ada, MI 49301
Phone (616) 274-1014

1471 E Beltline Ave NE
Ste 104
Grand Rapids, MI 49525
Phone (616) 233-3596

625 Kenmoor Ave SE
Ste 100
Grand Rapids, MI 49546

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1664323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1821712308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 KENMOOR AVE SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1471 E BELTLINE AVE NE STE 104",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495254548",
            "telephone_number": "616-577-8336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZWARYCH",
        "first_name": "KYLE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-28",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501302166",
            "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 28, 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.