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DR. TIMOTHY B VYROSTEK DC CCSP
NPI 1003929308
Chiropractor - Sports Physician in Conneaut Lake, PA

Active since August 17, 2006PECOS Enrolled
10633 STATE HIGHWAY 18, CONNEAUT LAKE, PA 16316(814) 382-1970(814) 382-3619 Get Directions Write a Review

NPPES record last updated: May 3, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Timothy B Vyrostek Dc Ccsp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. TIMOTHY B VYROSTEK DC CCSP (NPI 1003929308) is an individual sports physician in Conneaut Lake, Pennsylvania, licensed in Pennsylvania (4038) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS and is a graduate of Palmer College Chiropractic - Davenport (1997).

NPPES Registry Identity

NPI1003929308
Entity TypeIndividualMale
Primary Taxonomy111NS0005X
Provider Legal NameDR. TIMOTHY B VYROSTEKCredential: DC CCSP
Location Address10633 STATE HIGHWAY 18Conneaut Lake, PA 16316-3225
Mailing Address10633 State Highway 18Conneaut Lake, PA 16316-3225 · (814) 382-1970 · Fax (814) 382-3619
Phone(814) 382-1970
Fax(814) 382-3619
Sole ProprietorNo
Medical School CMSPalmer College Chiropractic - DavenportGraduated 1997
Enumeration DateAugust 17, 2006
Last NPPES UpdateMay 3, 2023
NPPES CertifiedMay 3, 2023
✔ NPI 1003929308 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyChiropractor · Sports PhysicianChiropractic Providers
Taxonomy Code111NS0005X
License✔ Licensed in PA · 4038
Definition
A sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) or the Certified Chiropractic Sports Physician (CCSP), sport specialty certifications from the American Chiropractic Board of Sports Physicians, have advanced training in the assessment, management and rehabilitation of sports related injuries. Extremity care, rehabilitation and soft tissue procedures are common skills utilized by these doctors. The specialty training covers a broad spectrum from the pediatric athlete to professional and Olympic athletes, and everything in between, using a variety of techniques and modalities.
Also ListedChiropractorTaxonomy 111N00000X · License DC007097L (PA)
10633 STATE HIGHWAY 18, Conneaut Lake, PA 16316
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Other Identifiers 3

Medicaid0016549110004PA
Other961159PA · Bcbs
Other205055PA · Upmc

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Timothy B Vyrostek Dc Ccsp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2860431202
PECOS Enrollment IDI20050426000853
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Timothy Vyrostek reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Lakeside Chiropractic PC
Same address
Chiropractor
10633 STATE HIGHWAY 18
Conneaut Lake, PA 16316
  • Reassigned Medicare billing, Pennsylvania enrollment
  • Medicare enrollment name: Lakeside Chiropractic P C
NPI 1992713903 (814) 382-1970

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAKESIDE CHIROPRACTIC PC
Chiropractor
10633 STATE HIGHWAY 18
CONNEAUT LAKE, PA 16316
Crawford County (814) 382-1970

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Timothy Vyrostek's NPI number?

The NPI number for Timothy Vyrostek is 1003929308. It was assigned to this individual provider in the NPPES registry on August 17, 2006.

Where is Timothy Vyrostek located?

Timothy Vyrostek practices at 10633 State Highway 18, Conneaut Lake, PA 16316. The listed phone number is (814) 382-1970.

What is Timothy Vyrostek's specialty?

The primary specialty registered for this NPI is Chiropractor, specializing in Sports Physician, with taxonomy code 111NS0005X.

Is Timothy Vyrostek enrolled in Medicare?

Yes. Timothy Vyrostek is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Timothy Vyrostek's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Timothy Vyrostek reassigns Medicare benefits to Lakeside Chiropractic PC (Conneaut Lake, PA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Timothy Vyrostek's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Timothy Vyrostek was last updated on May 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.