Jennilyn Roberts, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501301791 Issued in MI

Practice address

50912 Gratiot Ave
Chesterfield, MI 48051-3134

Phone

(586) 200-6603

Fax

(586) 200-6604

NPI assigned

Mar 27, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Jennilyn Munda Former name

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennilyn.roberts.p4@direct.athleticoltd.nextgenshare.com

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'S Best Physical Therapy, PLLC

  • Physical Therapist
  • Ira Township, MI
  • NPI 1972312510
  Medicare reassignment NPD Authorized official
• Spark Physical Therapy PLLC

  • Physical Therapist
  • Elmont, NY
  • NPI 1861104705
  NPD (past)
• Summit Physical Therapy and Rehabilitation, PLLC

  • Physical Therapist
  • Elmont, NY
  • NPI 1700327087
  NPD (past)

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

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1083957112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50912 GRATIOT AVE",
            "city": "CHESTERFIELD",
            "state": "MI",
            "postal_code": "480513134",
            "telephone_number": "586-200-6603",
            "fax_number": "586-200-6604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JENNILYN",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-27",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "032851",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501301791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNILYN",
            "last_name": "MUNDA",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ryan Jonathon Rinke, DDS
• Dakeda Riouse
• Emily Robbins
• Angela Roberts
• Enid Alison Roberts, M.D.
• Alliyah Robertson
• Chelsey Elizabeth Robertson
• Shiree Robidou
• Susan Robins
• Arianna Robinson

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.