Liju Mathew

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501021677 Issued in MI

Practice address

375 S Main St
Romeo, MI 48065-5185

Phone

(586) 589-3800

NPI assigned

Feb 28, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2002

Medicare assignment

May accept Medicare assignment

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.

• Powerback Rehabilitation LLC

  • Physical Therapist
  • Shelby Township, MI
  • NPI 1912226366
  Medicare reassignment NPD
• Powerback Rehabilitation LLC

  • Physical Therapist
  • Woodbridge, VA
  • NPI 1790640761
  NPD

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

{
    "created_epoch": "1709078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1184481970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6922 HAYMARKET",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483176324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 S MAIN ST",
            "city": "ROMEO",
            "state": "MI",
            "postal_code": "480655185",
            "telephone_number": "586-589-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "LIJU",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-28",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501021677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• M Magsoudi DDS PC
• Macomb County Access Center
• Mehrod Magsoudi, DDS
• Mark E. Hardwick
• Erica Lee Mason, MPT
• Michael J Delaura DDS PC
• Michelle Wahula, LMSW PLLC
• Nichole C Morris, ND
• Christy Moza, PT
• Lauren B Myers, PSY.D.

• Physical Therapist in Romeo, MI
• Providers in Romeo, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.