Individual provider Active NPI

Jaime Rodriguez, DPT

  • Physical Therapist
  • Southgate, MI
National Provider Identifier
1093215766
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501015204 Issued in MI
Practice address
15400 Northline Rd
Southgate, MI 48195-2689
Phone
(734) 285-0100
Fax
(734) 285-0101
NPI assigned
Feb 19, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501015204 MI Primary

Addresses

Primary practice location

15400 Northline Rd
Southgate, MI 48195-2689

Mailing address

33900 Harper Ave Ste 104
Clinton TWP, MI 48035-4258
Phone (586) 350-2644

Other practice location 1

1 Energy Plz Bldg 6th
Detroit, MI 48226-1221
Phone (313) 355-7750

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200218001941 MI Practitioner - Physical Therapist in Private Practice 5496182172 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.73 of 100Reported as group
Quality
87.86
Improvement activities
40
Cost
61.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Team Rehabilitation Services, LLC Physical Therapist CurrentSince Oct 24, 2021 Accepting new patients
Team Rehabilitation Services, LLC Physical Therapist CurrentSince Oct 24, 2021 Accepting new patients
William Beaumont Hospital Past Accepting new patients

Locations

16000 Southfield Rd
Allen Park, MI 48101
Phone (313) 359-8867

485 Columbia Ave E
Ste 10
Battle Creek, MI 49014
Phone (269) 719-8110

33900 Harper Ave
Ste 104
Clinton Twp, MI 48035
Phone (586) 416-9100

15400 Northline Rd
Southgate, MI 48195
Phone (734) 285-0100

25311 Little Mack Ave
St Clr Shores, MI 48081
Phone (586) 498-2400

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1518998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1093215766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33900 HARPER AVE STE 104",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480354258",
            "telephone_number": "586-350-2644",
            "fax_number": "586-541-3735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15400 NORTHLINE RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952689",
            "telephone_number": "734-285-0100",
            "fax_number": "734-285-0101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Energy Plz Bldg 6th",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482261221",
            "country_code": "US",
            "telephone_number": "313-355-7750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JAIME",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-19",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501015204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southgate, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; 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.