Individual provider Active NPI

John J Palazzo, DSC,PT,ECS

  • Clinical Electrophysiology Physical Therapist
  • Novi, MI
National Provider Identifier
1295877603
Registry record updated Jul 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Electrophysiology Physical TherapistTaxonomy code 2251E1300X
License
1276 Issued in MI
Practice address
26750 Providence Pkwy
Ste. 220
Novi, MI 48374-1211
Phone
(248) 342-9907
Fax
(248) 681-8571
NPI assigned
Feb 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Electrophysiology Physical Therapist 2251E1300X 1276 MI Primary

Addresses

Primary practice location

26750 Providence Pkwy
Ste. 220
Novi, MI 48374-1211

Mailing address

4385 Motorway Dr
Waterford, MI 48328-3451
Phone (248) 342-9907

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131121001612 MI Practitioner - Physical Therapist in Private Practice 2668608662 Practice locations: Livonia, MI; Novi, MI; Shelby Township, MI; Troy, MI; Warren, MI; Waterford, MI

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Ohio State University College of Medicine, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

26750 Providence Pkwy
Suite 220
Novi, MI 48374-1212
Phone (248) 342-9907

4385 Motorway Dr
Waterford, MI 48328-3451

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1276MIMDClinical Electrophysiology Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Neurolab Electrophysiology, Clinical PastSince Jul 18, 1990 Accepting new patients

Organizations & group practices 1

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": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373587200000",
    "number": "1295877603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4385 MOTORWAY DR",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483283451",
            "telephone_number": "248-342-9907",
            "fax_number": "248-681-8571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26750 PROVIDENCE PKWY",
            "address_2": "STE. 220",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483741211",
            "telephone_number": "248-342-9907",
            "fax_number": "248-681-8571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALAZZO",
        "first_name": "JOHN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DSC,PT,ECS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2013-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251E1300X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Electrophysiology, Clinical",
            "state": "MI",
            "license": "1276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2013; 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.