Madison Love Mirabitur I

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501303543 Issued in MI

Practice address

25900 Greenfield Rd Ste 100
Oak Park, MI 48237-1297

Phone

(248) 788-4300

NPI assigned

Jul 15, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Life Skills Village PLLCGroup PAC ID 2860624103, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Life Skills Village, PLLC

  • Community/Behavioral Health Agency
  • Oak Park, MI
  • NPI 1629316815
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1594771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1154939106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25900 GREENFIELD RD STE 100",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482371297",
            "telephone_number": "248-788-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25900 GREENFIELD RD STE 100",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482371297",
            "telephone_number": "248-788-4300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2775 E Lansing Dr",
            "address_purpose": "LOCATION",
            "city": "East Lansing",
            "state": "MI",
            "postal_code": "488237755",
            "country_code": "US",
            "telephone_number": "517-332-1616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRABITUR",
        "first_name": "MADISON",
        "middle_name": "LOVE",
        "name_suffix": "I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-15",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501303543",
            "primary": true
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quanta Milledge-Benjamin
• Carolyn Miller
• Jacob Allen Miller
• Marisa Mills, LLP
• Mindful Consulting Services
• Tiffany A Misangyi
• Gina Misuraca
• Mobile Dental Services, PLLC
• Moe Transportation LLC
• Christy Lynn Monaghan, MSW

• Physical Therapist in Oak Park, MI
• Providers in Oak Park, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; 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.