Individual provider Active NPI

Ananth Rathinasamy, PHYSICAL THERAPIST

  • Physical Therapist
  • Rochester Hills, MI
National Provider Identifier
1063840106
Registry record updated Dec 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501016692 Issued in MI
Practice address
1715 Grandview Dr
Rochester Hills, MI 48306-3133
Phone
(313) 707-6219
NPI assigned
Oct 29, 2013
Last updated
Dec 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2023

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 5501016692 MI Primary

Addresses

Primary practice location

1715 Grandview Dr
Rochester Hills, MI 48306-3133

Mailing address

1715 Grandview Dr
Rochester Hills, MI 48306-3133
Phone (313) 707-6219

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200113001651 MI Practitioner - Physical Therapist in Private Practice 8426483827 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michigan Luna Care Physical Therapy LLCGroup PAC ID 9032549217, 51 clinicians

Practice addresses (Care Compare)

Ann Arbor, MI 48108
Phone (866) 525-3175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501016692MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Luna Care Physical Therapy, LLC Physical Therapist CurrentSince Oct 9, 2025 Accepting new patients

Organizations & group practices 1

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": "1383004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1063840106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 GRANDVIEW DR",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483063133",
            "telephone_number": "313-707-6219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 GRANDVIEW DR",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483063133",
            "telephone_number": "313-707-6219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATHINASAMY",
        "first_name": "ANANTH",
        "name_prefix": "Mr.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-29",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501016692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; 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.