Individual provider Active NPI

Katherine T Hrisoulis, PT

  • Physical Therapist
  • Macomb, MI
National Provider Identifier
1295034213
Registry record updated May 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501015517 Issued in MI
Practice address
48800 Romeo Plank Rd
Macomb, MI 48044-2159
Phone
(586) 997-7100
Fax
(586) 997-7101
NPI assigned
Mar 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2018

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 5501015517 MI Primary

Addresses

Primary practice location

48800 Romeo Plank Rd
Macomb, MI 48044-2159

Mailing address

33900 Harper Ave
Suite 104
Clinton Township, MI 48035-4258
Phone (586) 350-2644

Other practice location 1

50625 Van Dyke Ave
Shelby Twp, MI 48317-1364
Phone (586) 997-7100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110720000772 MI Practitioner - Physical Therapist in Private Practice 1759559685 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HQ of St Clair LLCGroup PAC ID 9830633429, 5 clinicians

Practice addresses (Care Compare)

1193 S Carney Dr
Unit 12
St Clair, MI 48079-5569
Phone (810) 772-4422

Merit-based Incentive Payment System (MIPS)

Final score
81.73 of 100Reported as group
Quality
87.86
Improvement activities
40
Cost
61.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501015517MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Team Rehabilitation Services, LLC Physical Therapist CurrentSince Oct 24, 2021 Accepting new patients
HQ of St Clair LLC Physical Therapist CurrentSince May 8, 2025 Accepting new patients
Team Rehabilitation Services, LLC Physical Therapist CurrentSince Oct 24, 2021 Accepting new patients

Locations

16000 Southfield Rd
Allen Park, MI 48101
Phone (313) 359-8867

485 Columbia Ave E
Ste 10
Battle Creek, MI 49014
Phone (269) 719-8110

15520 19 Mile Rd
Ste 450
Clinton Twp, MI 48038
Phone (586) 416-2000

33900 Harper Ave
Ste 104
Clinton Twp, MI 48035
Phone (586) 416-9100

48800 Romeo Plank Rd
Macomb, MI 48044
Phone (586) 997-7100

1773 Star Batt Dr
Rochester Hills, MI 48309
Phone (248) 650-4720

4245 W 14 Mile Rd
Royal Oak, MI 48073
Phone (248) 549-8840

1193 S Carney Dr
Unit 12
St Clair, MI 48079
Phone (810) 772-4422

Organizations & group practices 3

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": "1300233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525910400000",
    "number": "1295034213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33900 HARPER AVE",
            "address_2": "SUITE 104",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480354258",
            "telephone_number": "586-350-2644",
            "fax_number": "586-541-3735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48800 ROMEO PLANK RD",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480442159",
            "telephone_number": "586-997-7100",
            "fax_number": "586-997-7101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50625 Van Dyke Ave",
            "address_purpose": "LOCATION",
            "city": "Shelby Twp",
            "state": "MI",
            "postal_code": "483171364",
            "country_code": "US",
            "telephone_number": "586-997-7100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HRISOULIS",
        "first_name": "KATHERINE",
        "middle_name": "T",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-16",
        "last_updated": "2018-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501015517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macomb, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2018; 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.