Individual provider Active NPI

Ryan Paul, DPT

  • Physical Therapist
  • Grand Rapids, MI
National Provider Identifier
1942083597
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501302659 Issued in MI
Practice address
1264 Plainfield Ave NE
Grand Rapids, MI 49505-4929
Phone
(616) 888-7993
Fax
(616) 432-2924
NPI assigned
Aug 17, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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 5501302659 MI Primary

Addresses

Primary practice location

1264 Plainfield Ave NE
Grand Rapids, MI 49505-4929

Mailing address

1311 Mamaroneck Ave Ste 140
White Plains, NY 10605-5224
Phone (914) 294-4050

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230821003195 MI Practitioner - Physical Therapist in Private Practice 1759743867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
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)

7559 36TH Ave
Hudsonville, MI 49426-7639
Phone (616) 369-0440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Michigan, LLC Physical Therapist CurrentSince Aug 16, 2023 Accepting new patients
Ivyrehab Northern PT, LLC Past Accepting new patients

Locations

9321 Cherry Valley Ave SE
Ste D
Caledonia, MI 49316
Phone (616) 536-9339

1264 Plainfield Ave NE
Grand Rapids, MI 49505
Phone (616) 888-7993

437 Butternut Dr
Holland, MI 49424
Phone (616) 355-3022

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

3837 W US Highway 10
Ludington, MI 49431
Phone (231) 674-5815

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

379 W Western Ave
Ste 101
Muskegon, MI 49440
Phone (231) 845-1906

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

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

204 W Upton Ave
Reed City, MI 49677
Phone (231) 465-4289

1311 Mamaroneck Ave
Ste 140
White Plains, NY 10605
Phone (914) 265-4838

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": "1692230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1942083597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224",
            "telephone_number": "914-294-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1264 PLAINFIELD AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495054929",
            "telephone_number": "616-888-7993",
            "fax_number": "616-432-2924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUL",
        "first_name": "RYAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-17",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501302659",
            "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 Aug 17, 2023; 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.