BROSTROM PHYSICAL THERAPY
NPI 1811209968
Physical Therapist in South Lyon, MI
About Brostrom Physical Therapy NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BROSTROM PHYSICAL THERAPY (NPI 1811209968) is a healthcare organization registered as a physical therapist in South Lyon, Michigan and active in the NPI registry since July 2010. The organization lists Matthew Alexander Brostrom, Owner/director Of Physical Therapy, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
- Diagnose and manage movement dysfunction and enhance physical and functional abilities.
- Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
- Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
- Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
- Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
Other Names 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Brostrom Physical Therapy is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
10Medicare enrollment records show 10 clinicians reassign Medicare billing to Brostrom Physical Therapy, which bills Medicare for the services they deliver. Of these, 7 practice at this address. They are listed nearest first.
Clinicians, nearest first (10)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Spine And Extremity Institute Of South Lyon, L.L.C.'s NPI number?
The NPI number for Spine And Extremity Institute Of South Lyon, L.L.C. is 1811209968. It was assigned to this organization in the NPPES registry on July 6, 2010. The provider is also known as Brostrom Physical Therapy.
Where is Spine And Extremity Institute Of South Lyon, L.L.C. located?
Spine And Extremity Institute Of South Lyon, L.L.C. is located at 22180 Pontiac Trail Suite E, South Lyon, MI 48178. The listed phone number is (248) 446-0155.
What is Spine And Extremity Institute Of South Lyon, L.L.C.'s specialty?
The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.
Is Spine And Extremity Institute Of South Lyon, L.L.C. enrolled in Medicare?
Yes. Spine And Extremity Institute Of South Lyon, L.L.C. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Spine And Extremity Institute Of South Lyon, L.L.C.?
According to the CMS Revalidation Reassignment List (October 2026 release), 10 clinicians, all in Physical Therapist in Private Practice, reassign their Medicare billing to Spine And Extremity Institute Of South Lyon, L.L.C.. A 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 the clinician's services. Of these, 7 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Spine And Extremity Institute Of South Lyon, L.L.C. accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 2 other insurers list Spine And Extremity Institute Of South Lyon, L.L.C. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Spine And Extremity Institute Of South Lyon, L.L.C. was last updated on July 6, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.
# Brostrom Physical Therapy · NPI 1811209968
Physical Therapist organization in South Lyon, Michigan. Organization record, active in the CMS NPPES registry since July 6, 2010.
## Identity
- **NPI:** 1811209968 (Entity type: Organization)
- **Enumerated:** July 6, 2010
- **Primary specialty:** Physical Therapist · taxonomy 225100000X
- **Legal business name:** Spine And Extremity Institute Of South Lyon, L.l.c.
- **Organization subpart:** No
- **Authorized official:** Matthew Brostrom, OWNER/DIRECTOR OF PHYSICAL THERAPY
## Practice location
- **Address:** 22180 PONTIAC TRAIL, SUITE E, South Lyon, MI 48178-9097
- **Phone:** (248) 446-0155 · **Fax:** (248) 446-0177
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 10 clinicians (Physical Therapist in Private Practice) reassign Medicare billing to this organization (form CMS-855R); 7 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 6, 2010
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Source: [NPI Profile](https://npiprofile.com/npi/1811209968) · Data from the CMS NPPES public registry.