Individual provider Active NPI

Nausheen Haroon

  • Physical Therapist
  • Plymouth, MI
National Provider Identifier
1073859658
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501017162 Issued in MI
Practice address
47635 Five Mile Rd
Plymouth, MI 48170-2418
Phone
(734) 489-6254
Fax
(734) 418-7356
NPI assigned
Dec 31, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 99055195A IN
Physical Therapist 225100000X 24933 MD
Physical Therapist 225100000X 070-021759 IL
Physical Therapist 225100000X 5501017162 MI Primary

Addresses

Primary practice location

47635 Five Mile Rd
Plymouth, MI 48170-2418

Mailing address

1311 Mamaroneck Ave Ste 140
White Plains, NY 10605-5224
Phone (914) 294-4050

Other practice location 1

120 E Higgins Rd
Elk Grove Village, IL 60007-1434
Phone (847) 285-4200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230221000353 MI Practitioner - Physical Therapist in Private Practice 1759509078 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
City University of New York School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Rehabilitation Inc.Group PAC ID 1456346683, 3 clinicians
Ivyrehab Michigan LLCGroup PAC ID 6901165893, 156 clinicians

Practice addresses (Care Compare)

2050 N Haggerty Rd
Suite 280
Canton, MI 48187-3796
Phone (734) 846-8590

47635 Five Mile Rd
Plymouth, MI 48170-2418
Phone (734) 489-6254

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070-021759ILMDPhysical Therapist
99055195AINMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Fyzpt-I LLC Physical Therapist CurrentSince Aug 5, 2024 Accepting new patients
Synergy Physical Therapy and Wellness LLC Physical Therapist CurrentSince Jan 31, 2023 Accepting new patients
Ivyrehab Michigan, LLC Physical Therapist CurrentSince Aug 1, 2023 Accepting new patients
Michigan Fyzpt-II Fyzical Physical Therapist CurrentSince Aug 5, 2024 Accepting new patients
Functional Endocrinologist PLLC PastSince Mar 1, 2025 Accepting new patients
Life Fitness Physical Therapy LLC Physical Therapist Past Accepting new patients

Locations

16925 Haggerty Rd
Northville, MI 48168
Phone (248) 826-5600

41430 Grand River Ave
Ste B
Novi, MI 48375
Phone (248) 826-5600

26850 Providence Pkwy
Ste 365
Novi, MI 48374
Phone (248) 380-3550

1764 S Ortonville Rd
Ste 400
Ortonville, MI 48462
Phone (248) 793-5730

1764 S Ortonville Rd
Ortonville, MI 48462
Phone (248) 793-5730

47635 Five Mile Rd
Plymouth, MI 48170
Phone (734) 489-6254

2066 S Wayne Rd
Westland, MI 48186
Phone (734) 895-9257

1311 Mamaroneck Ave
Ste 140
White Plains, NY 10605
Phone (914) 265-4838

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1356912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1073859658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224",
            "telephone_number": "914-294-4050",
            "fax_number": "631-760-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47635 FIVE MILE RD",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481702418",
            "telephone_number": "734-489-6254",
            "fax_number": "734-418-7356"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 E Higgins Rd",
            "address_purpose": "LOCATION",
            "city": "Elk Grove Village",
            "state": "IL",
            "postal_code": "600071434",
            "country_code": "US",
            "telephone_number": "847-285-4200",
            "fax_number": "847-885-0130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAROON",
        "first_name": "NAUSHEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-31",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "99055195A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "24933",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-021759",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501017162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.