Samuel Lazarus Alexander, R.P.T
Individual provider Active NPI Physical Therapist · Taylor, MI
NPI 1013071893 · NPPES record last updated Oct 10, 2011
Key facts
- NPI
- 1013071893
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 5501007036 (MI)
- Practice address
- 10501 Telegraph Rd
Taylor, MI 48180-3375 - Phone
- (313) 544-1400
- Fax
- (313) 483-0585
- NPI assigned
- Dec 19, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- JBNP Services, LLC
Practice addresses (Care Compare)
38221 Plymouth Rd
Suite 3
Livonia, MI 48150-1051
Phone (734) 221-0236
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110205000025 | MI | Practitioner - Physical Therapist in Private Practice | 3678753811 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501007036 | MI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| JBNP Services, LLC | Current |
Accepting new patients | |
| JBNP Services, LLC | Current |
Accepting new patients | |
| Tmi East, Inc. | Current |
Accepting new patients |
Locations
38221 Plymouth Rd
Ste 3
Livonia, MI 48150
Phone (734) 221-0236
851 Penniman Ave
Plymouth, MI 48170
Phone (248) 349-9595
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501007036 | MI | Yes |
Addresses
Primary practice location
10501 Telegraph Rd
Taylor, MI 48180-3375
Mailing address
40761 Deer Pines Dr
Canton, MI 48188-2233
Phone (734) 934-4537
Other providers in Taylor, MI
- Ahmad Ali Al-Jamal
- Ghada Alawie
- Ridhwan Albaneh
- Lai-Lah M Albert
- Harriet Alexander
- Ali Hameed Ali
- Bibi Aisha Ali
- Hassan N Ali
- Sofiah Ali
- Suha N Alkhateeb
All providers in Taylor, MI · Physical Therapist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.