Individual provider Active NPI

Olivia Roe, PT

  • Physical Therapist
  • East Lansing, MI
National Provider Identifier
1265259188
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501303534 Issued in MI
Practice address
4660 S Hagadorn Rd Ste 400
East Lansing, MI 48823-5353
Phone
(517) 355-7648
Fax
(517) 432-1319
NPI assigned
Sep 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 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 5501303534 MI Primary

Addresses

Primary practice location

4660 S Hagadorn Rd Ste 400
East Lansing, MI 48823-5353

Mailing address

804 Service Rd Ste A202
East Lansing, MI 48824-7015
Phone (517) 353-4911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241007000262 MI Practitioner - Physical Therapist in Private Practice 4688105307 Reassigns benefits to 1 organization
I20250603002579 MN Practitioner - Physical Therapist in Private Practice 4688105307 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

2525 University Ave SE
Minneapolis, MN 55414-3205
Phone (612) 672-6697

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince Jun 1, 2025 Accepting new patients
Msu Health Care Inc Current Accepting new patients
Msu Health Care Inc. Physical Therapist CurrentSince Sep 26, 2024 Accepting new patients
Fairview Express Care CurrentSince Jun 1, 2025 Accepting new patients

Locations

4660 S Hagadorn Rd
Ste 500
East Lansing, MI 48823
Phone (517) 432-6144

4660 S Hagadorn Rd
Ste 400
East Lansing, MI 48823
Phone (517) 355-7648

804 Service Rd
Ste A202
East Lansing, MI 48824
Phone (517) 884-2976

3400 W 66th St
Ste 290
Minneapolis, MN 55435
Phone (952) 836-3637

2525 University Ave SE
Minneapolis, MN 55414
Phone (612) 273-7827

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

Organizations & group practices 5

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": "1727049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1265259188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SERVICE RD STE A202",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247015",
            "telephone_number": "517-353-4911",
            "fax_number": "517-432-3928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 S HAGADORN RD STE 400",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488235353",
            "telephone_number": "517-355-7648",
            "fax_number": "517-432-1319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROE",
        "first_name": "OLIVIA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-23",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501303534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.