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

Derek Zagon

Individual provider Physical Therapist · NPI 1184577132

Derek Zagon is a Physical Therapist in Private Practice in Portage, Michigan. Qualified in 2025, 1 year ago. Practices with Alliance Physical Therapy Group LLC, a 34-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
1
Licensed in
MI
In the registry since
2026

Practice location Address checks out

6016 Lovers Ln
Portage, MI 49002-3050
Phone: (269) 248-1946
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 5501304417 (MI)

Record details

NPI number1184577132
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 18, 2026
Last updated in NPPESFebruary 18, 2026
Certification dateFebruary 18, 2026
Mailing address625 Kenmoor Ave Se Ste 100, Grand Rapids, MI 49546-2395

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Alliance Physical Therapy Group Llc — 34 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Portage