Elija Kamal Sansom, M.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501010471 Issued in MI

Practice address

8381 E 12 Mile Rd
Warren, MI 48093-2769

Phone

(586) 698-1999

Fax

(586) 576-6531

NPI assigned

May 24, 2007

Sex

Male

Sole proprietor

No

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, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michigan Rehabilitation Specialists of Fowlerville LLCGroup PAC ID 6204730393, 125 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

85.78 of 100Reported as group

Quality

89.5

Improvement activities

40

Cost

71.87

Medicare enrollment (NPD)

Enrolled

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.

• Michigan Rehabilitation Specialists of Fowlerville LLC

  • Physical Therapist
  • Fowlerville, MI
  • NPI 1669531166
  Medicare reassignment Care Compare group NPD
• Michigan Luna Care Physical Therapy, LLC

  • Physical Therapist
  • Ann Arbor, MI
  • NPI 1003448994
  Medicare reassignment NPD
• Michigan Rehabilitation Specialists of Fowlerville, LLC

  • Durable Medical Equipment & Medical Supplies
  • Dexter, MI
  • NPI 1407525892
  NPD

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1073724720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "866-370-8206",
            "fax_number": "517-435-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8381 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480932769",
            "telephone_number": "586-698-1999",
            "fax_number": "586-576-6531"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "261 Mack Ave",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "48201",
            "country_code": "US",
            "telephone_number": "313-745-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANSOM",
        "first_name": "ELIJA",
        "middle_name": "KAMAL",
        "name_prefix": "Mr.",
        "credential": "M.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501010471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Marie Samulski-Doe, LMSW
• Bens Jean-Gerald Sandaire, D.O.
• Ariel Sanders
• Krystal L Sandifer
• Todd Sanfield
• Molly Santin, LLMSW
• Andres G Santiviago, MD
• Mariam F Saparamadu, MSW
• Harvey S Saperstein, DPM
• Molly Elizabeth Saputo, OTR/L

• Physical Therapist in Warren, MI
• Providers in Warren, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.