Physical Medicine& Rehabilitation Consultant and Pain Management,P.C.

Primary specialty

Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X

License

5101011761 Issued in MI

Legal business name

PHYSICAL MEDICINE& REHABILITATION CONSULTANT AND PAIN MANAGEMENT,P.C.

Practice address

21675 Coolidge Hwy
Ste a
Oak Park, MI 48237-3171

Phone

(248) 546-3467

Fax

(248) 546-3477

NPI assigned

Mar 20, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Dawit Teklehaimanot, D.O.NPI 1689766065

Title

Physician

Phone

(734) 717-3816

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dawit Teklehaimanot, D.O.

  • Specialist
  • Southfield, MI
  • NPI 1689766065
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446681600000",
    "number": "1265603013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21675 COOLIDGE HWY",
            "address_2": "STE A",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482373171",
            "telephone_number": "248-546-3467",
            "fax_number": "248-546-3477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21675 COOLIDGE HWY",
            "address_2": "STE A",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482373171",
            "telephone_number": "248-546-3467",
            "fax_number": "248-546-3477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL MEDICINE& REHABILITATION CONSULTANT AND PAIN MANAGEMENT,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-20",
        "last_updated": "2015-11-05",
        "status": "A",
        "authorized_official_last_name": "TEKLEHAIMANOT",
        "authorized_official_first_name": "DAWIT",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "734-717-3816",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "MI",
            "license": "5101011761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4493556",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Destiny Peterson, PHD
• Paul M Petre, M.D.
• Eman Petros, GENERAL DENTIST
• Phoenix Medical Associates
• Phoenix Medical Associates LLC
• Physical Rehab Service LLC
• Alanna Doria Piche
• Mary Pietrzyk, OT
• Heather Pillars
• Pinewood Dental Associates P.C.

• Comprehensive Outpatient Rehabilitation Facility (CORF) in Oak Park, MI
• Providers in Oak Park, MI by specialty
• Comprehensive Outpatient Rehabilitation Facility (CORF) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.