Individual provider Active NPI

Robert Brian John Bertoni

  • Physical Therapist
  • Chelsea, MI
National Provider Identifier
1891284097
Registry record updated May 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501008190 Issued in MI
Practice address
775 S Main St
Chelsea, MI 48118-1383
Phone
(734) 593-5600
Fax
(734) 593-6375
NPI assigned
May 3, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2018

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 5501008190 MI Primary

Addresses

Primary practice location

775 S Main St
Chelsea, MI 48118-1383

Mailing address

34505 W 12 Mile Rd Ste 200
Farmington Hills, MI 48331-3286
Phone (734) 593-5600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190201002089 MI Practitioner - Physical Therapist in Private Practice 5193062891 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Michigan Medical School, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Probility Therapy ServicesGroup PAC ID 6305897414, 106 clinicians

Practice addresses (Care Compare)

3145 W Clark Rd
Suite 102
Ypsilanti, MI 48197-1120
Phone 73471277022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501008190MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Probility Therapy Services Physical Therapist CurrentSince Jan 4, 2019 Accepting new patients
Probility Therapy Services CurrentSince Jan 4, 2019 Accepting new patients

Locations

3145 W Clark Rd
Ste 102
Ypsilanti, MI 48197
Phone (734) 528-9760

3145 W Clark Rd
Ste 106
Ypsilanti, MI 48197
Phone (734) 528-9760

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": "1525305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525305600000",
    "number": "1891284097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34505 W 12 MILE RD STE 200",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483313286",
            "telephone_number": "734-593-5600",
            "fax_number": "734-593-6375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 S MAIN ST",
            "city": "CHELSEA",
            "state": "MI",
            "postal_code": "481181383",
            "telephone_number": "734-593-5600",
            "fax_number": "734-593-6375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTONI",
        "first_name": "ROBERT",
        "middle_name": "BRIAN JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-03",
        "last_updated": "2018-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501008190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chelsea, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2018; 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.