Individual provider Active NPI

Daniel Vincent Venditti, DPT

  • Physical Therapist
  • Shelby TWP, MI
National Provider Identifier
1063047876
Registry record updated Mar 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501019537 Issued in MI
Practice address
51064 Filomena Dr
Shelby TWP, MI 48315-2937
Phone
(586) 566-5116
Fax
(586) 566-5146
NPI assigned
Mar 12, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501019537 MI Primary

Addresses

Primary practice location

51064 Filomena Dr
Shelby TWP, MI 48315-2937

Mailing address

51064 Filomena Dr
Shelby TWP, MI 48315-2937
Phone (586) 566-5116

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200331002916 MI Practitioner - Physical Therapist in Private Practice 2466881131 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Oakland College of Medicine and Surgery, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Silver Pine Medical Group PLCGroup PAC ID 8325020332, 39 clinicians

Practice addresses (Care Compare)

13860 Canal Rd
Sterling Heights, MI 48313-2110
Phone (586) 726-4823

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501019537MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Edge LLC CurrentSince Mar 16, 2020 Accepting new patients
Silver Pine Medical Group PLC CurrentSince Aug 15, 2022 Accepting new patients

Locations

51064 Filomena Dr
Shelby Township, MI 48315
Phone (586) 531-6860

13860 Canal Rd
Sterling Heights, MI 48313
Phone (248) 254-8900

43455 Schoenherr Rd
Ste 2
Sterling Hts, MI 48313
Phone (586) 884-2712

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1583971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1063047876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51064 FILOMENA DR",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483152937",
            "telephone_number": "586-566-5116",
            "fax_number": "586-566-5146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51064 FILOMENA DR",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483152937",
            "telephone_number": "586-566-5116",
            "fax_number": "586-566-5146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENDITTI",
        "first_name": "DANIEL",
        "middle_name": "VINCENT",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-12",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501019537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2020; 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.