Active NPI
Triamsee Bandala
- Physical Therapist
- Pontiac, MI
National Provider Identifier
1023554433
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501017670
- Practice address
- 900 Auburn Ave Ste 100
Pontiac, MI 48342-3300 - Phone
- (248) 332-8600
- NPI assigned
- Jan 9, 2017
- Last updated
- Jan 9, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501017670 | MI | Primary |
Addresses
Primary practice location
900 Auburn Ave Ste 100
Pontiac, MI 48342-3300
Mailing address
2659 Lantern LN
Apt# 305
Auburn Hills, MI 48326-4220
Phone (610) 333-5244
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501017670 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1483920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483920000000",
"number": "1023554433",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2659 LANTERN LN",
"address_2": "APT# 305",
"city": "AUBURN HILLS",
"state": "MI",
"postal_code": "483264220",
"telephone_number": "610-333-5244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 AUBURN AVE STE 100",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483423300",
"telephone_number": "248-332-8600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANDALA",
"first_name": "TRIAMSEE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-01-09",
"last_updated": "2017-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501017670",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pontiac, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.