Individual provider Active NPI

Babak Dehkordi, DPT

  • Physical Therapist
  • Southfield, MI
National Provider Identifier
1104473230
Registry record updated Nov 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501019215 Issued in MI
Practice address
24901 Northwestern Hwy Ste 113
Southfield, MI 48075-2200
Phone
(844) 369-9955
NPI assigned
Aug 22, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2019

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 5501019215 MI Primary

Addresses

Primary practice location

24901 Northwestern Hwy Ste 113
Southfield, MI 48075-2200

Mailing address

10819 Oak LN Apt 19106
Van Buren TWP, MI 48111-4711
Phone (734) 834-1076

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200519002697 MI Practitioner - Physical Therapist in Private Practice 7911338397 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

17020 Fort St
Riverview, MI 48193-6626
Phone (734) 759-1356

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501019215MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Rehabilitation Specialists of Fowlerville, LLC CurrentSince Mar 31, 2021 Accepting new patients
Michigan Rehabilitation Specialists of Fowlerville LLC Physical Therapist CurrentSince Mar 31, 2021 Accepting new patients
Michigan Luna Care Physical Therapy, LLC Physical Therapist CurrentSince May 18, 2020 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Mar 29, 2021 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Mar 29, 2021 Accepting new patients

Locations

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

1801 W Maumee St
Ste 125
Adrian, MI 49221
Phone (517) 264-6141

2570 Jackson Ave
Ste C
Ann Arbor, MI 48103
Phone (734) 823-7820

10078 Lapeer Rd
Ste B
Davison, MI 48423
Phone (810) 653-6200

14349 Telegraph Rd
Redford, MI 48239
Phone (313) 541-2886

17020 Fort St
Riverview, MI 48193
Phone (734) 759-1356

Interoperability endpoints

  • Direct secure messaging: babak.dehkordi.p4@direct.athleticoltd.nextgenshare.com

Organizations & group practices 5

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": "1566432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574640000000",
    "number": "1104473230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10819 OAK LN APT 19106",
            "city": "VAN BUREN TWP",
            "state": "MI",
            "postal_code": "481114711",
            "telephone_number": "734-834-1076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24901 NORTHWESTERN HWY STE 113",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752200",
            "telephone_number": "844-369-9955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHKORDI",
        "first_name": "BABAK",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-22",
        "last_updated": "2019-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501019215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2019; 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.