Individual provider Active NPI

Tyler Finch

  • Physical Therapist
  • Grand Haven, MI
National Provider Identifier
1912455171
Registry record updated Jul 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
16760 Lincoln St
Grand Haven, MI 49417-8864
Phone
(616) 935-3300
Fax
(616) 935-3322
NPI assigned
Sep 16, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2019

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

16760 Lincoln St
Grand Haven, MI 49417-8864

Mailing address

1377 Motor Pkwy
Ste 307
Islandia, NY 11749-5258
Phone (631) 580-5200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161010000662 MI Practitioner - Physical Therapist in Private Practice 6305134206 Reassigns benefits to 1 organization

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
Ivyrehab Michigan LLCGroup PAC ID 6901165893, 156 clinicians

Practice addresses (Care Compare)

400 Rounds Dr
Fenton, MI 48430-1724
Phone (810) 750-1996

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Michigan, LLC Physical Therapist CurrentSince Jul 29, 2019 Accepting new patients

Locations

400 Rounds Dr
Fenton, MI 48430
Phone (810) 629-0530

7559 36th Ave
Hudsonville, MI 49426
Phone (616) 369-0440

7559 36th Ave
Ste 200
Hudsonville, MI 49426
Phone (616) 369-0440

135 S Milford Rd
Milford, MI 48381
Phone (248) 685-7272

1764 S Ortonville Rd
Ortonville, MI 48462
Phone (248) 793-5730

1764 S Ortonville Rd
Ste 400
Ortonville, MI 48462
Phone (248) 793-5730

1377 Motor Pkwy
Ste 307
Ronkonkoma, NY 11749

Organizations & group practices 1

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": "1473984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1912455171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1377 MOTOR PKWY",
            "address_2": "STE 307",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "117495258",
            "telephone_number": "631-580-5200",
            "fax_number": "631-580-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16760 LINCOLN ST",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494178864",
            "telephone_number": "616-935-3300",
            "fax_number": "616-935-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINCH",
        "first_name": "TYLER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-16",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Haven, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2019; 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.