Individual provider Active NPI

Fatema Idris Taher

  • Orthopedic Physical Therapist
  • Warren, MI
National Provider Identifier
1114118775
Registry record updated Jul 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
5501008227 Issued in MI
Practice address
29703 Hoover Rd
Warren, MI 48093-8901
Phone
(586) 582-0340
NPI assigned
Aug 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 5501008227 MI Primary

Addresses

Primary practice location

29703 Hoover Rd
Warren, MI 48093-8901

Mailing address

27472 Schoenherr Rd 130
Warren, MI 48088-6675
Phone (586) 439-6243

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051011000616 MI Practitioner - Physical Therapist in Private Practice 1658396452 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mendelson Orthopedics PCGroup PAC ID 8426008368, 69 clinicians

Practice addresses (Care Compare)

13488 E 11 Mile Rd
Mendelson Kornblum Physical Therapy
Warren, MI 48089-1366
Phone (586) 439-6243

35735 Mound Rd
Sterling Heights, MI 48310-4728

36622 5 Mile Rd
Livonia, MI 48154-1900
Phone (734) 542-0200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mendelson Orthopedics PC CurrentSince Jan 1, 2011 Accepting new patients
Mendelson Orthopedics PC CurrentSince Jan 1, 2011 Accepting new patients
Mendelson Orthopedics PC Past Accepting new patients

Locations

36622 5 Mile Rd
Ste 102
Livonia, MI 48154
Phone (734) 542-9770

14555 Levan Rd
Ste 215
Livonia, MI 48154
Phone (734) 542-0200

36622 5 Mile Rd
Livonia, MI 48154
Phone (734) 542-0200

35735 Mound Rd
Ste 101
Sterling Heights, MI 48310
Phone (586) 510-7997

13488 E 11 Mile Rd
Warren, MI 48089
Phone (586) 439-6243

11900 E 12 Mile Rd
Ste 110
Warren, MI 48093
Phone (586) 261-1960

27472 Schoenherr Rd
Ste 130
Warren, MI 48088
Phone (586) 439-6243

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436486400000",
    "number": "1114118775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27472 SCHOENHERR RD 130",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480886675",
            "telephone_number": "586-439-6243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29703 HOOVER RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480938901",
            "telephone_number": "586-582-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAHER",
        "first_name": "FATEMA",
        "middle_name": "IDRIS",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-07",
        "last_updated": "2015-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MI",
            "license": "5501008227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2015; 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.