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

Madison Polen, PT

Individual provider Physical Therapist · NPI 1912676677

Madison Polen, PT is a Physical Therapist in Private Practice in Grand Rapids, Michigan. Qualified in 2021, 5 years ago. Practices with Athletico Ltd, a 2,186-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
5
Licensed in
MI
In the registry since
2021
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

2807 Lake Michigan Dr NW Ste 1
Grand Rapids, MI 49504-5831
Phone: (616) 828-1326
Fax: (616) 228-9578
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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 5501020243 (MI)

Record details

NPI number1912676677
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT
Sole proprietorNo
NPI enumeratedSeptember 7, 2021
Last updated in NPPESSeptember 7, 2021
Certification dateSeptember 7, 2021

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Athletico Ltd — 2186 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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