DR. TIMOTHY B VYROSTEK DC CCSP NPI 1003929308

NPI Information

  • NPI: 1003929308
  • Provider Name: DR. TIMOTHY B VYROSTEK, DC CCSP
  • Classification: Chiropractor - 111NS0005X
  • Specialization: Sports Physician
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 10633 STATE HIGHWAY 18
    CONNEAUT LAKE, PA
    ZIP 16316
  • Phone: (814) 382-1970

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NPI Details

DR. Timothy B Vyrostek, DC CCSP is a sports physician chiropractor in Conneaut Lake, PA. The provider is a sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) or the Certified Chiropractic Sports Physician (CCSP), sport specialty certifications from the American Chiropractic Board of Sports Physicians, have advanced training in the assessment, management and rehabilitation of sports related injuries. Extremity care, rehabilitation and soft tissue procedures are common skills utilized by these doctors. The specialty training covers a broad spectrum from the pediatric athlete to professional and Olympic athletes, and everything in between, using a variety of techniques and modalities. DR. Timothy B Vyrostek, DC CCSP NPI is 1003929308. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

10633 STATE HIGHWAY 18
CONNEAUT LAKE, PA
ZIP 16316-225
Phone: (814) 382-1970
Fax: (814) 382-3619

The NPI 1003929308 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/17/2006 and was last updated on 5/3/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1111N00000XChiropractorDC007097LPENNSYLVANIANo
2111NS0005XChiropractorSports Physician4038PENNSYLVANIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10016549110004MEDICAIDPENNSYLVANIA
2961159OTHERPENNSYLVANIABCBS
3205055OTHERPENNSYLVANIAUPMC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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