Individual provider Active NPI

Susan Ubaydi Colangelo

  • Physical Therapist
  • Royal Oak, MI
National Provider Identifier
1144722646
Registry record updated Mar 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501007004 Issued in MI
Practice address
4949 Coolidge Hwy
Royal Oak, MI 48073-1026
Phone
(248) 655-5700
Fax
(248) 655-5701
NPI assigned
Mar 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2018

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 5501007004 MI Primary

Addresses

Primary practice location

4949 Coolidge Hwy
Royal Oak, MI 48073-1026

Mailing address

2151 Edgestone Dr
Sterling Heights, MI 48314-3776
Phone (586) 940-3786

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5501007004MIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1519862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519862400000",
    "number": "1144722646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2151 EDGESTONE DR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483143776",
            "telephone_number": "586-940-3786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4949 COOLIDGE HWY",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480731026",
            "telephone_number": "248-655-5700",
            "fax_number": "248-655-5701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLANGELO",
        "first_name": "SUSAN",
        "middle_name": "UBAYDI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-01",
        "last_updated": "2018-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501007004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.