Individual provider Active NPI

Roxanne Renae Kudwa, MSPT

  • Physical Therapist
  • Lansing, MI
National Provider Identifier
1104132877
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501009453 Issued in MI
Practice address
3404 Patient Care Dr
Lansing, MI 48911-4217
Phone
(517) 267-0200
Fax
(517) 267-1877
NPI assigned
Aug 19, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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 5501009453 MI Primary

Addresses

Primary practice location

3404 Patient Care Dr
Lansing, MI 48911-4217

Mailing address

3404 Patient Care Dr
Lansing, MI 48911-4217
Phone (517) 267-0200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040224000053 MI Practitioner - Physical Therapist in Private Practice 6204722689 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michigan Orthopedic Center P CGroup PAC ID 8527026442, 30 clinicians

Practice addresses (Care Compare)

3404 Patient Care Dr
Lansing, MI 48911-4217
Phone (517) 267-0200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501009453MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
K 13 Physical Therapy & Sports Medicine PC Physical Therapist CurrentSince Aug 19, 2010 Accepting new patients
Michigan Orthopedic Center P C CurrentSince May 16, 2025 Accepting new patients

Locations

3404 Patient Care Dr
Lansing, MI 48911
Phone (517) 267-0200

1925 W Grand River Ave
Okemos, MI 48864
Phone (517) 267-0200

1507 Waterford Pkwy
Saint Johns, MI 48879
Phone (989) 227-5404

Organizations & group practices 2

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": "1282176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1104132877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3404 PATIENT CARE DR",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489114217",
            "telephone_number": "517-267-0200",
            "fax_number": "517-267-1877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3404 PATIENT CARE DR",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489114217",
            "telephone_number": "517-267-0200",
            "fax_number": "517-267-1877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUDWA",
        "first_name": "ROXANNE",
        "middle_name": "RENAE",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-19",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501009453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; 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.