Active NPI
Amanda Jayashki Nugaliyadda Hanson, PT
- Physical Therapist
- Southfield, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501303372
- Practice address
- 22250 Providence Dr Ste 405
Southfield, MI 48075-6212 - Phone
- (866) 974-2673
- Fax
- (866) 939-2673
- NPI assigned
- Apr 5, 2018
- Last updated
- Aug 7, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501303372 | MI | Primary |
| Physical Therapy Assistant | 225200000X | 5502005497 | MI |
Addresses
Primary practice location
22250 Providence Dr Ste 405
Southfield, MI 48075-6212
Mailing address
33900 Harper Ave Ste 104
Clinton TWP, MI 48035-4258
Other practice location 1
19930 Poinciana
Redford, MI 48240-1654
Phone (734) 228-4101
Other practice location 2
26750 Providence Pkwy Ste 240
Novi, MI 48374-1211
Phone (248) 687-7440
Other practice location 3
14800 Farmington Rd
Livonia, MI 48154-5461
Phone (734) 743-8880
Other practice location 4
2700 E Grand River Ave
Howell, MI 48843-8550
Phone (517) 225-3040
Other names 1
- Amanda Nugaliyadda
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
22250 Providence Dr
Suite 401
Southfield, MI 48075-6212
Phone (248) 563-0306
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501303372 | MI | MD | Physical Therapist |
| 5502005497 | MI | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Porretta Center for Orthopaedic Surgery, PLLC | Physical Therapist | Current | Accepting new patients |
| The Porretta Center for Orthopaedic Surgery, PLLC | Current | Accepting new patients | |
| Team Rehabilitation Services, LLC | Physical Therapist | Current | Accepting new patients |
| Team Rehabilitation Services, LLC | Physical Therapist | Current | Accepting new patients |
| The Porretta Center for Orthopaedic Surgery, PLLC | Past | Accepting new patients | |
| Medical X-Ray Consultants, LTD | Past | Accepting new patients | |
| The Porretta Center for Orthopaedic Surgery, PLLC | Past | Accepting new patients | |
| The Porretta Center for Orthopaedic Surgery, PLLC | Past | Accepting new patients |
Locations
18444 N 25th Ave
Ste 310
Phoenix, AZ 85023
Phone (623) 241-8706
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
33900 Harper Ave
Ste 104
Clinton Twp, MI 48035
Phone (586) 416-9100
26750 Providence Pkwy
#240
Novi, MI 48374
Phone (248) 349-7843
26750 Providence Pkwy
Ste 240
Novi, MI 48374
Phone (248) 687-7440
22250 Providence Dr
Ste 40
Southfield, MI 48075
Phone (248) 563-0306
22250 Providence Dr
Ste 401
Southfield, MI 48075
Phone (248) 349-7015
22250 Providence Dr
Ste 405
Southfield, MI 48075
Phone (248) 465-5140
27652 Franklin Rd
Southfield, MI 48034
Phone (248) 359-8700
Interoperability endpoints
- amanda.nugaliyadda.1@22724.direct.athenahealth.com
Organizations & group practices 9
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba The CORE Institute
- Orthopaedic Surgery Physician
- Novi, MI
- NPI 1306818331
Physical Therapist
-
- Orthopaedic Surgery Physician
- Novi, MI
- NPI 1134082357
-
- Physical Therapist
- Bloomfield Hills, MI
- NPI 1548932619
-
- Customized Equipment (DME)
- Howell, MI
- NPI 1407428584
-
- Physical Therapist
- Marietta, GA
- NPI 1508538158
-
dba The CORE Institute
- Durable Medical Equipment & Medical Supplies
- Novi, MI
- NPI 1053758391
-
dba The CORE Institute
- Durable Medical Equipment & Medical Supplies
- Southfield, MI
- NPI 1396182804
-
dba The CORE Institute
- Durable Medical Equipment & Medical Supplies
- Brighton, MI
- NPI 1639576440
-
- Vascular & Interventional Radiology Physician
- Alexandria, MN
- NPI 1386601383
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786060800000",
"number": "1295231389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33900 HARPER AVE STE 104",
"city": "CLINTON TWP",
"state": "MI",
"postal_code": "480354258"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22250 PROVIDENCE DR STE 405",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480756212",
"telephone_number": "866-974-2673",
"fax_number": "866-939-2673"
}
],
"practiceLocations": [
{
"address_1": "19930 Poinciana",
"address_purpose": "LOCATION",
"city": "Redford",
"state": "MI",
"postal_code": "482401654",
"country_code": "US",
"telephone_number": "734-228-4101",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "26750 Providence Pkwy Ste 240",
"address_purpose": "LOCATION",
"city": "Novi",
"state": "MI",
"postal_code": "483741211",
"country_code": "US",
"telephone_number": "248-687-7440",
"fax_number": "248-687-7441",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "14800 Farmington Rd",
"address_purpose": "LOCATION",
"city": "Livonia",
"state": "MI",
"postal_code": "481545461",
"country_code": "US",
"telephone_number": "734-743-8880",
"fax_number": "734-743-8889",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2700 E Grand River Ave",
"address_purpose": "LOCATION",
"city": "Howell",
"state": "MI",
"postal_code": "488438550",
"country_code": "US",
"telephone_number": "517-225-3040",
"fax_number": "517-225-3045",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HANSON",
"first_name": "AMANDA",
"middle_name": "JAYASHKI NUGALIYADDA",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-05",
"last_updated": "2026-08-07",
"certification_date": "2026-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501303372",
"primary": true
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MI",
"license": "5502005497",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "AMANDA",
"last_name": "NUGALIYADDA",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2026; 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.