Individual provider Active NPI

Munifa Mohibi, LPT

  • Physical Therapist
  • Saginaw, MI
National Provider Identifier
1194063339
Registry record updated Jan 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501005402 Issued in MI
Practice address
2575 McLeod Dr N
Suite B
Saginaw, MI 48604-2857
Phone
(989) 921-1132
Fax
(989) 921-1134
NPI assigned
Jan 23, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 5501005402 MI
Physical Therapist 225100000X 5501005402 MI Primary

Addresses

Primary practice location

2575 McLeod Dr N
Suite B
Saginaw, MI 48604-2857

Mailing address

2575 McLeod Dr N
Suite B
Saginaw, MI 48604-2857
Phone (989) 921-1132

Other identifiers 1

IdentifierTypeStateIssuer
1699829119MedicaidMI

Other names 1

  • Munifa Attarwalatt Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050809000156 MI Practitioner - Physical Therapist in Private Practice 7719916949 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501005402MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Bay Health Centers CurrentSince Apr 17, 2019 Accepting new patients
Great Lakes Bay Health Centers CurrentSince Apr 17, 2019 Accepting new patients
Functional Rehab Services PC CurrentSince Nov 1, 2010 Accepting new patients

Locations

501 Lapeer Ave
Saginaw, MI 48607
Phone (989) 753-6000

2575 McLeod Dr N
Ste B
Saginaw, MI 48604
Phone (989) 921-1132

501 Lapeer Ave
#R
Saginaw, MI 48607
Phone (989) 753-6000

Interoperability endpoints

  • Direct secure messaging: munifa.mohibi.1@27771.direct.athenahealth.com

Organizations & group practices 3

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": "1358899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1194063339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2575 MCLEOD DR N",
            "address_2": "SUITE B",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486042857",
            "telephone_number": "989-921-1132",
            "fax_number": "989-921-1134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2575 MCLEOD DR N",
            "address_2": "SUITE B",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486042857",
            "telephone_number": "989-921-1132",
            "fax_number": "989-921-1134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHIBI",
        "first_name": "MUNIFA",
        "credential": "LPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-23",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "5501005402",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501005402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699829119",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MUNIFA",
            "last_name": "ATTARWALATT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saginaw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2020; 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.