Active NPI
Marcia Boileau, PT
- Physical Therapist
- Novi, MI
National Provider Identifier
1043710031
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501003146
- Practice address
- 26850 Providence Pkwy Ste 163
Novi, MI 48374-1254 - Phone
- (248) 465-4190
- Fax
- (248) 465-4894
- NPI assigned
- Feb 15, 2018
- Sex
- Female
- Sole proprietor
- No
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 | 5501003146 | MI | Primary |
Addresses
Primary practice location
26850 Providence Pkwy Ste 163
Novi, MI 48374-1254
Mailing address
26850 Providence Pkwy Ste 163
Novi, MI 48374-1254
Phone (248) 465-4190
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 |
|---|---|---|---|
| 5501003146 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518652800000",
"number": "1043710031",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26850 PROVIDENCE PKWY STE 163",
"city": "NOVI",
"state": "MI",
"postal_code": "483741254",
"telephone_number": "248-465-4190",
"fax_number": "248-465-4894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26850 PROVIDENCE PKWY STE 163",
"city": "NOVI",
"state": "MI",
"postal_code": "483741254",
"telephone_number": "248-465-4190",
"fax_number": "248-465-4894"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOILEAU",
"first_name": "MARCIA",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-15",
"last_updated": "2018-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501003146",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Novi, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.