Individual provider Active NPI

Nicholas Mychalowych, DPT

  • Physical Therapist
  • Woodhaven, MI
National Provider Identifier
1194340596
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501019581 Issued in MI
Practice address
20059 King Rd
Woodhaven, MI 48183-1032
Phone
(734) 365-5112
Fax
(734) 365-5115
NPI assigned
Jun 11, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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 5501019581 MI Primary

Addresses

Primary practice location

20059 King Rd
Woodhaven, MI 48183-1032

Mailing address

33900 Harper Ave Ste 104
Clinton TWP, MI 48035-4258
Phone (586) 350-2644

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200803000637 MI Practitioner - Physical Therapist in Private Practice 1951726371 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab Michigan LLCGroup PAC ID 6901165893, 156 clinicians

Practice addresses (Care Compare)

846 E Grand River Ave
Unit B
Howell, MI 48843-2432
Phone (517) 672-5777

Merit-based Incentive Payment System (MIPS)

Final score
81.73 of 100Reported as group
Quality
87.86
Improvement activities
40
Cost
61.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501019581MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Team Rehabilitation Services, LLC Physical Therapist CurrentSince Oct 24, 2021 Accepting new patients
Ivyrehab Michigan, LLC Physical Therapist CurrentSince Jul 28, 2025 Accepting new patients
Team Rehabilitation Services, LLC Physical Therapist CurrentSince Oct 24, 2021 Accepting new patients

Locations

16000 Southfield Rd
Allen Park, MI 48101
Phone (313) 359-8867

485 Columbia Ave E
Ste 10
Battle Creek, MI 49014
Phone (269) 719-8110

42727 Ford Rd
Canton, MI 48187
Phone (734) 418-4866

33900 Harper Ave
Ste 104
Clinton Twp, MI 48035
Phone (586) 416-9100

846 E Grand River Ave
Unit B
Howell, MI 48843
Phone (517) 672-5777

135 S Milford Rd
Ste 307
Milford, MI 48381

135 S Milford Rd
Milford, MI 48381
Phone (248) 685-7272

43440 W Oaks Dr
Novi, MI 48377
Phone (248) 380-3550

1764 S Ortonville Rd
Ortonville, MI 48462
Phone (248) 793-5730

1764 S Ortonville Rd
Ste 400
Ortonville, MI 48462
Phone (248) 793-5730

47635 Five Mile Rd
Plymouth, MI 48170
Phone (734) 489-6254

20059 King Rd
Woodhaven, MI 48183
Phone (734) 364-5112

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": "1591833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1194340596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33900 HARPER AVE STE 104",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480354258",
            "telephone_number": "586-350-2644",
            "fax_number": "586-541-3735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20059 KING RD",
            "city": "WOODHAVEN",
            "state": "MI",
            "postal_code": "481831032",
            "telephone_number": "734-365-5112",
            "fax_number": "734-365-5115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYCHALOWYCH",
        "first_name": "NICHOLAS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-11",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501019581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodhaven, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.