Individual provider Active NPI

Muhammad Shoaib, PHYSICAL THERAPIST

  • Physical Therapist
  • Saint Clair Shores, MI
National Provider Identifier
1083106207
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501019420 Issued in MI
Practice address
29150 Harper Ave
Saint Clair Shores, MI 48081-1218
Phone
(586) 779-0911
NPI assigned
Jun 4, 2018
Last updated
Jan 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501019420 MI Primary
Physical Therapist 225100000X 041653-1 NY

Addresses

Primary practice location

29150 Harper Ave
Saint Clair Shores, MI 48081-1218

Mailing address

7597 Acorn Hill CT
West Bloomfield, MI 48323-4016
Phone (313) 918-9113

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241211001613 MI Practitioner - Physical Therapist in Private Practice 8628482122 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501019420MIMDPhysical Therapist
041653-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aquatic Solutions Physical Therapy LLC Physical Therapist CurrentSince Nov 1, 2024 Accepting new patients
Mobility Plus Rehab Services Inc. Physical Therapist PastSince Jan 22, 2023 Accepting new patients
Advance Laser Therapy PLC PastSince Dec 18, 2022 Accepting new patients

Locations

25591 Coolidge Hwy
Oak Park, MI 48237
Phone (248) 331-9490

14501 Telegraph Rd
Redford, MI 48239
Phone (248) 693-4188

Organizations & group practices 3

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": "1528070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1083106207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7597 ACORN HILL CT",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483234016",
            "telephone_number": "313-918-9113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29150 HARPER AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811218",
            "telephone_number": "586-779-0911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOAIB",
        "first_name": "MUHAMMAD",
        "name_prefix": "Mr.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-04",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501019420",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "041653-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; 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.