Antwan Faraj, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501017840 Issued in MI

Practice address

668 E 9 Mile Rd
Ferndale, MI 48220-1962

Phone

(248) 733-5052

NPI assigned

Aug 18, 2016

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Tony Faraj Other name

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peak Performance Solutions LLCGroup PAC ID 1254723356, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Peak Performance Solutions LLC

  • Physical Therapist
  • Ferndale, MI
  • NPI 1992393417

  MI, Physical Therapist

  Medicare reassignment Care Compare group NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1471478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610236800000",
    "number": "1003361007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "344 E HARRY AVE",
            "city": "HAZEL PARK",
            "state": "MI",
            "postal_code": "480302055",
            "telephone_number": "586-871-4805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "668 E 9 MILE RD",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482201962",
            "telephone_number": "248-733-5052"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36654 Carriage Dr",
            "address_purpose": "LOCATION",
            "city": "Sterling Heights",
            "state": "MI",
            "postal_code": "483104469",
            "country_code": "US",
            "telephone_number": "586-871-4805",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "344 E Harry Ave",
            "address_purpose": "LOCATION",
            "city": "Hazel Park",
            "state": "MI",
            "postal_code": "480302055",
            "country_code": "US",
            "telephone_number": "586-871-4805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARAJ",
        "first_name": "ANTWAN",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-18",
        "last_updated": "2021-01-10",
        "certification_date": "2021-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501017840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TONY",
            "last_name": "FARAJ",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• All providers in Ferndale, MI
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.