Active NPI
Prabaharan Selvaraj
- Physical Therapist
- Cass City, MI
National Provider Identifier
1225321813
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501015285
- Practice address
- 4782 Hospital Dr
Cass City, MI 48726-1049 - Phone
- (989) 872-2174
- Fax
- (989) 872-2204
- NPI assigned
- May 16, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501015285 | MI | Primary |
Addresses
Primary practice location
4782 Hospital Dr
Cass City, MI 48726-1049
Mailing address
4782 Hospital Dr
Cass City, MI 48726-1049
Phone (989) 872-2174
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2007
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
6374 Chestnut Blvd
Cass City, MI 48726-1054
7376 Glen Eagle Dr
Bay City, MI 48706-9316
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501015285 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384819200000",
"number": "1225321813",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4782 HOSPITAL DR",
"city": "CASS CITY",
"state": "MI",
"postal_code": "487261049",
"telephone_number": "989-872-2174",
"fax_number": "989-872-2204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4782 HOSPITAL DR",
"city": "CASS CITY",
"state": "MI",
"postal_code": "487261049",
"telephone_number": "989-872-2174",
"fax_number": "989-872-2204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELVARAJ",
"first_name": "PRABAHARAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-05-16",
"last_updated": "2013-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501015285",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cass City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.