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

Michael Bolosan, DPT

Individual provider Physical Therapist · NPI 1720648595

Michael Bolosan, DPT is a Physical Therapist in Private Practice in Newport News, Virginia. Qualified in 2019, 7 years ago. Practices with Tidewater Physicians Multispecialty Group, PC, a 269-clinician group and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
7
Licensed in
VA
In the registry since
2019
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

860 Omni Blvd Ste 103
Newport News, VA 23606-4430
Phone: (757) 223-9403
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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 2305212899 (VA)

Record details

NPI number1720648595
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorYes
NPI enumeratedJune 14, 2019
Last updated in NPPESJune 18, 2019

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Tidewater Physicians Multispecialty Group, Pc — 269 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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