Sudhakaran Jegadeesh, PT, MBA

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

5501007156 Issued in MI

Practice address

17418 W 10 Mile Rd
Southfield, MI 48075-2951

Phone

(248) 552-1012

Fax

(248) 552-0657

NPI assigned

May 30, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Business Administration

State licenses

Practice roles

Locations

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.

• Sudhakaran Jegadeesh Inc

  • Orthopedic Physical Therapist
  • Southfield, MI
  • NPI 1093091316
  Medicare reassignment NPD Authorized official
• Ron Physical Therapy P.C

  • Physical Therapist
  • Southfield, MI
  • NPI 1710189162
  NPD (past) Authorized official

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317945600000",
    "number": "1326249103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17418 W 10 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752951",
            "telephone_number": "248-552-1012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17418 W 10 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752951",
            "telephone_number": "248-552-1012",
            "fax_number": "248-552-0657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEGADEESH",
        "first_name": "SUDHAKARAN",
        "credential": "PT, MBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2011-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501007156",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MI",
            "license": "5501007156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeevaka Yapa DDS PC
• Tomyia M Jefferson
• Jeffrey M Last PHD PLLC
• Jeffrey T Najor MD PLLC
• Tamika Jeffries
• Ayne A Jeilani, BEHAVIORAL TECHNICIA
• Lakeithia Jenkins
• Markea Jenkins
• Stacey Jenkins
• Tessy C Jenkins, M.D.

• Orthopedic Physical Therapist in Southfield, MI
• Providers in Southfield, MI by specialty
• Orthopedic Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; 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.