Anbu Punniyakotti, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501007005 Issued in MI

Practice address

49628 Great Falls Rd
Canton, MI 48188-3459

Phone

(734) 397-2830

Fax

(734) 397-4918

NPI assigned

Aug 26, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Meridian Rehab LLCGroup PAC ID 3072826957, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Meridian Rehab LLC

  • Physical Therapist
  • Westland, MI
  • NPI 1043651979
  Medicare reassignment Care Compare group NPD
• Prime Therapy Services PC

  • Physical Therapist
  • Canton, MI
  • NPI 1245448018
  NPD (past) Authorized official

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

{
    "created_epoch": "1188086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188086400000",
    "number": "1083807796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49628 GREAT FALLS RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481883459",
            "telephone_number": "734-397-2830",
            "fax_number": "734-397-4918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49628 GREAT FALLS RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481883459",
            "telephone_number": "734-397-2830",
            "fax_number": "734-397-4918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUNNIYAKOTTI",
        "first_name": "ANBU",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-26",
        "last_updated": "2007-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501007005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "65-O-H2-2460-0",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lucinda Pryor
• Colleen M Przybyla, M.S. CCC-SLP
• Louis Mark Przybylski, M.A.
• Psychiatric Consulting Services PC
• Psychiatric Support Services PLLC
• Aysha Qamar, DO
• Mahir Qasem
• Jacklyn L Quade, MD
• John William Quinlisk
• Nicole Quirk, M.A., CCC-SLP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2007; 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.