Individual provider Active NPI

Gramos Pallaska, DPT

  • Physical Therapist
  • Brighton, MI
National Provider Identifier
1245778398
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501018107 Issued in MI
Practice address
5757 Whitmore Lake Rd Ste 900
Brighton, MI 48116-1956
Phone
(810) 220-5793
Fax
(810) 220-5805
NPI assigned
Feb 9, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 5501018107 MI Primary

Addresses

Primary practice location

5757 Whitmore Lake Rd Ste 900
Brighton, MI 48116-1956

Mailing address

5757 Whitmore Lake Rd Ste 900
Brighton, MI 48116-1956
Phone (810) 220-5793

Other practice location 1

1665 Hamilton Rd Ste 100
Okemos, MI 48864-1809
Phone (517) 349-1110

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170906002787 MI Practitioner - Physical Therapist in Private Practice 5193098564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Wayne State University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Neurosurgical Associates PCGroup PAC ID 9739139759, 34 clinicians

Practice addresses (Care Compare)

29275 Northwestern Hwy
Suite 100
Southfield, MI 48034-5700
Phone (248) 351-6300

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501018107MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
University Neurosurgical Associates, PC CurrentSince Jan 27, 2022 Accepting new patients
University Neurosurgical Associates PC CurrentSince Jan 27, 2022 Accepting new patients

Locations

2319 Momentum Pl
Chicago, IL 60689

29275 Northwestern Hwy
Ste 100
Southfield, MI 48034
Phone (248) 351-6300

Interoperability endpoints

  • Direct secure messaging: gramos.pallaskadpt.p1@direct.mhsineuro.nextgenshare.com

Organizations & group practices 2

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": "1486598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1245778398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5757 WHITMORE LAKE RD STE 900",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481161956",
            "telephone_number": "810-220-5793",
            "fax_number": "810-220-5805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5757 WHITMORE LAKE RD STE 900",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481161956",
            "telephone_number": "810-220-5793",
            "fax_number": "810-220-5805"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1665 Hamilton Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Okemos",
            "state": "MI",
            "postal_code": "488641809",
            "country_code": "US",
            "telephone_number": "517-349-1110",
            "fax_number": "517-349-6892",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALLASKA",
        "first_name": "GRAMOS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-09",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501018107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.