Individual provider Active NPI

Mikhail Freylikh, MD

  • Physical Medicine & Rehabilitation Physician
  • Philadelphia, PA
National Provider Identifier
1003853219
Registry record updated Jul 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
MD058411L Issued in PA
Practice address
12033 Bustleton Ave
Philadelphia, PA 19116-2107
Phone
(215) 671-8840
Fax
(215) 671-1933
NPI assigned
May 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X MD058411L PA Primary

Addresses

Primary practice location

12033 Bustleton Ave
Philadelphia, PA 19116-2107

Mailing address

28 Dalton Way
Holland, PA 18966-5304
Phone (215) 968-5159

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110309000192 PA Practitioner - Physical Medicine and Rehabilitation 1658553813 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

826 Bustleton Pike
Suite 201
Feasterville Trevose, PA 19053-6064
Phone (215) 671-8840

Hospital & facility affiliations

  • Jefferson Einstein Philadelphia Hospital Hospital, Philadelphia, PA, CCN 390142
  • St Mary Medical Center Hospital, Langhorne, PA, CCN 390258

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
MLN Rehab., Inc. Physical Medicine & Rehabilitation CurrentSince Jul 1, 1997 Accepting new patients

Locations

826 Bustleton Pike
Ste 201
Feasterville Trevose, PA 19053
Phone (215) 671-8840

12033 Bustleton Ave
Philadelphia, PA 19116
Phone (215) 671-8840

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278028800000",
    "number": "1003853219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 DALTON WAY",
            "city": "HOLLAND",
            "state": "PA",
            "postal_code": "189665304",
            "telephone_number": "215-968-5159",
            "fax_number": "214-968-5159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12033 BUSTLETON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191162107",
            "telephone_number": "215-671-8840",
            "fax_number": "215-671-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREYLIKH",
        "first_name": "MIKHAIL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2010-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "MD058411L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.