Gaurav Mitra

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501013172 Issued in MI

Practice address

1769 S Cedar St
Imlay City, MI 48444-1300

Phone

(810) 724-0421

Fax

(810) 721-0423

NPI assigned

Oct 17, 2008

Sex

Male

Sole proprietor

No

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 Luna Care Physical Therapy, LLC

  • Physical Therapist
  • Ann Arbor, MI
  • NPI 1003448994
  Medicare reassignment Care Compare group NPD MI, Physical Therapist

Specialty

Physical Therapist in Private Practice

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michigan Luna Care Physical Therapy LLC 51 clinicians

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in MI

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 24, 2009.

{
    "created_epoch": "1224201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237852800000",
    "number": "1104078443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1769 S CEDAR ST",
            "city": "IMLAY CITY",
            "state": "MI",
            "postal_code": "484441300",
            "telephone_number": "810-724-0421",
            "fax_number": "810-721-0423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1769 S CEDAR ST",
            "city": "IMLAY CITY",
            "state": "MI",
            "postal_code": "484441300",
            "telephone_number": "810-724-0421",
            "fax_number": "810-721-0423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITRA",
        "first_name": "GAURAV",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-17",
        "last_updated": "2009-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501013172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tonya Marlin
• Rebecca McInerney-Logan, RPH
• Haley Rohde McNary, PA-C
• Michael R Warnars D.C.
• Miller Family Chiropractic PLLC
• Sadie Murray, RN
• Narayan Medtech Equipment LLC
• Jill Marie Nevorski, NP-C
• Henry D. Nichols, D.D.S.
• David Andrew Noffert, D.D.S.

• All providers in Imlay City, MI
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2009; 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.