Naga Prashant Maddali, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501014273 Issued in MI

Practice address

5428 Metropolitan Pkwy
Sterling Heights, MI 48310-4103

Phone

(586) 977-0001

Fax

(586) 977-0002

NPI assigned

Oct 18, 2009

Last updated

Oct 18, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Select Rehabilitation, LLC

  • Rehabilitation Clinic/Center
  • Glenview, IL
  • NPI 1346368248

  MI, Physical Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1255824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255824000000",
    "number": "1053647594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5428 METROPOLITAN PKWY",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483104103",
            "telephone_number": "586-977-0001",
            "fax_number": "586-977-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5428 METROPOLITAN PKWY",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483104103",
            "telephone_number": "586-977-0001",
            "fax_number": "586-977-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDALI",
        "first_name": "NAGA",
        "middle_name": "PRASHANT",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-18",
        "last_updated": "2009-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501014273",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05009974A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Macomb Pharmacy, Inc.
• Macomb Physicians Group, PLLC
• Macomb Rehab Methods
• Macomb Vision Clinic, Inc.
• Gary Ray Macon, D.C.
• Peyton Madden, CTRS
• Kristen Maddock
• Dominika Madej, LLMSW
• Madek Family Dental PC (Mark a Madek, DDS)
• Sheela Madipelli

• 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 Oct 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.