Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Benjamin Mark Mastbergen

Individual provider Physical Therapist · NPI 1487171872

Benjamin Mark Mastbergen is a Physical Therapist in Private Practice in Wyoming, Michigan. Qualified in 2017, 9 years ago. Practices with Hulst Jepsen Physical Therapy Inc, a 133-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
9
Licensed in
MI
In the registry since
2017
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Practice location Address checks out

5570 Wilson Ave SW Ste A
Wyoming, MI 49418-8867
Phone: (616) 855-1495
Fax: (616) 855-1496
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 5501018373 (MI)

Record details

NPI number1487171872
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 25, 2017
Last updated in NPPESJuly 18, 2018
Mailing address4761 Lake Michigan Dr Nw Ste A, Grand Rapids, MI 49534-6300

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Hulst Jepsen Physical Therapy Inc — 133 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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