Individual provider Active NPI

Lance Thaddeus Wozniak, P.T., D.P.T.

  • Physical Therapist
  • Bingham Farms, MI
National Provider Identifier
1164574935
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501011569 Issued in MI
Practice address
24255 W 13 Mile Rd Ste 100
Bingham Farms, MI 48025-4345
Phone
(248) 988-8085
Fax
(248) 988-8565
NPI assigned
Jan 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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 5501011569 MI Primary

Addresses

Primary practice location

24255 W 13 Mile Rd Ste 100
Bingham Farms, MI 48025-4345

Mailing address

2001 Butterfield Rd Ste 1600
Downers Grove, IL 60515-1211

Other identifiers 1

IdentifierTypeStateIssuer
1164574935MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070417000223 MI Practitioner - Physical Therapist in Private Practice 7416052667 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12787 S Saginaw St
4 Ati Physical Therapy
Grand Blanc, MI 48439-1830
Phone (810) 771-7631

Merit-based Incentive Payment System (MIPS)

Final score
85.78 of 100Reported as group
Quality
89.5
Improvement activities
40
Cost
71.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501011569MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Rehabilitation Specialists of Fowlerville LLC Physical Therapist CurrentSince Oct 15, 2018 Accepting new patients
Michigan Rehabilitation Specialists of Fowlerville, LLC CurrentSince Oct 15, 2018 Accepting new patients
Oakland Orthopedic Partners PC PastSince Mar 15, 2011 Accepting new patients
Empower Physical Therapy and Fitness PastSince Sep 28, 2015 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

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

2001 Butterfield Rd
Ste 1600
Downers Grove, IL 60515

5700 Jackson Rd
Ann Arbor, MI 48103
Phone (734) 926-4710

7164 N Main St
Clarkston, MI 48346
Phone (248) 625-6400

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

1429 Flushing Rd
#A
Flushing, MI 48433
Phone (810) 487-9128

12787 S Saginaw St
Ste C4
Grand Blanc, MI 48439
Phone (810) 771-7631

15201 N Holly Rd
Ste B
Holly, MI 48442
Phone (248) 531-0002

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14148/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1164574935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24255 W 13 MILE RD STE 100",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254345",
            "telephone_number": "248-988-8085",
            "fax_number": "248-988-8565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOZNIAK",
        "first_name": "LANCE",
        "middle_name": "THADDEUS",
        "credential": "P.T., D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501011569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164574935",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bingham Farms, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; 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.