Ebram M Fanous, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501011728 Issued in MI

Practice address

36430 Van Dyke Ave
Sterling Heights, MI 48312-2746

Phone

(586) 335-8182

Fax

(248) 757-2330

NPI assigned

Aug 9, 2007

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

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Theramax Rehab IncGroup PAC ID 9739282278, 8 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.

• Theramax Rehab, Inc

  • Occupational Therapist
  • Troy, MI
  • NPI 1851458608

  Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1053502468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3381 HIDDEN OAKS LN",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483243256",
            "telephone_number": "586-335-8182",
            "fax_number": "248-757-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36430 VAN DYKE AVE",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483122746",
            "telephone_number": "586-335-8182",
            "fax_number": "248-757-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANOUS",
        "first_name": "EBRAM",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-09",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501011728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Fadi Farhat, D.D.S.
• Farmbrook Family Dentistry
• Fast Track Physical Therapy & Rehab Center LLC
• Megan Fauls

• Physical Therapist in Sterling Heights, MI
• Providers in Sterling Heights, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.