Shivakumar Subbarayan, RPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

3076 Northridge Rd
Hale, MI 48739-9277

Phone

(989) 728-0242

Fax

(989) 728-1144

NPI assigned

Apr 19, 2007

Sex

Male

Sole proprietor

No

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.

• Progress Physical Therapy Inc

  • Physical Therapist
  • Hale, MI
  • NPI 1053301341

  MI, Physical Therapist

  Medicare reassignment Care Compare group NPD Authorized official

Specialty

Physical Therapist in Private Practice

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Progress Physical Therapy Inc 23 clinicians

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 5, 2025.

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1225255367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3076 NORTHRIDGE RD",
            "city": "HALE",
            "state": "MI",
            "postal_code": "487399277",
            "telephone_number": "989-728-0242",
            "fax_number": "989-728-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3076 NORTHRIDGE RD",
            "city": "HALE",
            "state": "MI",
            "postal_code": "487399277",
            "telephone_number": "989-728-0242",
            "fax_number": "989-728-1144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUBBARAYAN",
        "first_name": "SHIVAKUMAR",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": null,
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "5501008794",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4621772",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vania Raykova, MD
• Kelli Jill Rembowski, BBA, CAC, CHW
• Vera Jo Smock, RPH
• Carrie Ann Standen, DNP, PMHNP-BC
• Sterling Area Health Center
• Linda Marie Thompson, NEED TO CARE FOR DAD
• Thunder Bay Community Health Service, Inc
• Beth A Weaver, NP
• Jessica Lynn Wilson, MSN FNP-BC
• Paul Curtis Wolkens Jr.

• All providers in Hale, MI
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.