Health Source Physical Therapy Center, Inc.
NPI 1083624969 · Physical Therapy Clinic/Center · Portland, MI
Enrolled with Medicare as Part a Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Health Source Physical Therapy Center, Inc. is a Physical Therapy Clinic/Center organization in Portland, MI (NPI 1083624969).
Provider details
- NPI number
- 1083624969
- Entity type
- Organization
- Primary specialty
- Physical Therapy Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jaya Boddu, President(517) 647-1000
- License
- 5501005495 (MI)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-08-09
- Last updated
- 2011-12-20
Frequently asked questions
- What is Health Source Physical Therapy Center, Inc.'s NPI number?
- Health Source Physical Therapy Center, Inc.'s National Provider Identifier (NPI) is 1083624969, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Health Source Physical Therapy Center, Inc.?
- Health Source Physical Therapy Center, Inc. is classified in the NPPES registry as Physical Therapy Clinic/Center (Ambulatory Health Care Facilities).
- Where is Health Source Physical Therapy Center, Inc. located?
- Health Source Physical Therapy Center, Inc.'s practice location on file with NPPES is 1447 E Grand River Ave, Portland, MI 48875-1631.
- What is Health Source Physical Therapy Center, Inc.'s phone number?
- The practice phone number listed in the NPPES registry for Health Source Physical Therapy Center, Inc. is (517) 647-1000.
- Does Health Source Physical Therapy Center, Inc. accept Medicare?
- Health Source Physical Therapy Center, Inc. is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Health Source Physical Therapy Center, Inc.?
- The authorized official listed on Health Source Physical Therapy Center, Inc.'s NPPES record is Jaya Boddu, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Health Source Physical Therapy Center, Inc.'s NPI active?
- Yes — Health Source Physical Therapy Center, Inc.'s NPI (1083624969) is active in the NPPES registry as of the last update on 2011-12-20.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.