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

Jake Paul

Individual provider Physical Therapist · NPI 1225988959

Jake Paul is a Physical Therapist in Private Practice in Grosse Pointe Woods, Michigan. Qualified in 2025, 1 year ago. Practices with Athletico Ltd, a 2,186-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
1
Licensed in
MI
In the registry since
2026
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Practice location Address checks out

20873 Mack Ave
Grosse Pointe Woods, MI 48236-1313
Phone: (313) 466-7884
Fax: (313) 464-0001
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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 5501304403 (MI)

Record details

NPI number1225988959
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 2, 2026
Last updated in NPPESMay 7, 2026
Certification dateMay 7, 2026
Mailing address2122 York Rd Ste 300, Oak Brook, IL 60523-1925

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 Athletico Ltd — 2186 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Grosse Pointe Woods