Organization Active NPI

Brainwave Rehabilitation Specialists LLC

  • Physical Medicine & Rehabilitation Physician
  • Taylor, MI
National Provider Identifier
1174320956
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
BRAINWAVE REHABILITATION SPECIALISTS LLC
Practice address
12575 Telegraph Rd
Taylor, MI 48180-4019
Phone
(313) 548-7822
NPI assigned
Feb 27, 2025
Last updated
Feb 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Authorized official

Name
Wendy ContrerasNPI 1932586906
Title
Owner
Phone
(313) 548-7822

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X NU Primary

Addresses

Primary practice location

12575 Telegraph Rd
Taylor, MI 48180-4019

Mailing address

12575 Telegraph Rd
Taylor, MI 48180-4019
Phone (313) 548-7822

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250408001735 MI Part B Supplier - Clinic/Group Practice 9133643497 Receives reassigned benefits from 1 practitioner
Practice locations: Taylor, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1740614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740614400000",
    "number": "1174320956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12575 TELEGRAPH RD",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481804019",
            "telephone_number": "313-548-7822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12575 TELEGRAPH RD",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481804019",
            "telephone_number": "313-548-7822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAINWAVE REHABILITATION SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-27",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A",
        "authorized_official_last_name": "CONTRERAS",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-548-7822"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.