Evan Walsh Mazur
NPI 1215452479ActiveIndividual· Physical Therapist· Grand Rapids, MI
Physical Therapist with Advent Rehabilitation, LLC, practicing in Grand Rapids, Michigan. Enrolled in Medicare as practitioner - physical therapist in private practice and practitioner - physical therapist in private practice.
Overview
| NPI | 1215452479 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | Yes |
| NPI issued | Aug 9, 2017 |
| Last updated in NPPES | Feb 5, 2025 |
| Certified by provider | Feb 5, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 5501303510 | MI |
| Physical Therapist | 225100000X | PTL.0013686 | CO |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (CO); Practitioner - Physical Therapist in Private Practice (MI) |
|---|
Education and affiliations
| Graduation year | 2015 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Advent Rehabilitation, LLCGrand Rapids, MI · 57 clinicians
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