Individual provider Active NPI

Mark Joseph Heitchue, MPT

  • Physical Therapist
  • Bloomfield Hills, MI
National Provider Identifier
1972806479
Registry record updated Feb 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501005804 Issued in MI
Practice address
60 W Big Beaver Rd Ste 125
Bloomfield Hills, MI 48304-3915
Phone
(248) 309-8900
NPI assigned
Dec 6, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2017

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 5501005804 MI Primary

Addresses

Primary practice location

60 W Big Beaver Rd Ste 125
Bloomfield Hills, MI 48304-3915

Mailing address

60 W Big Beaver Rd Ste 125
Bloomfield Hills, MI 48304-3915
Phone (248) 309-8900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501005804MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
HQ of Bloomfield Hills LLC Physical Therapist CurrentSince Aug 4, 2024 Accepting new patients
Quality Care Rehabilitation Professionals, Inc Physical Therapist PastSince Mar 1, 2018 Accepting new patients
Quality Care Rehabilitation Professionals Past Accepting new patients

Locations

60 W Big Beaver Rd
Ste 125
Bloomfld Hls, MI 48304
Phone (248) 309-8900

Organizations & group practices 3

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": "1291593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487548800000",
    "number": "1972806479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 W BIG BEAVER RD STE 125",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483043915",
            "telephone_number": "248-309-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 W BIG BEAVER RD STE 125",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483043915",
            "telephone_number": "248-309-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEITCHUE",
        "first_name": "MARK",
        "middle_name": "JOSEPH",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-06",
        "last_updated": "2017-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501005804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.