Individual provider Active NPI

Renee Marie Pawloski, PT

  • Physical Therapist
  • Canton, MI
National Provider Identifier
1346503786
Registry record updated Jan 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501015917 Issued in MI
Practice address
42955 Ford Rd
Canton, MI 48187-3377
Phone
(734) 981-2100
Fax
(734) 981-2622
NPI assigned
Jun 20, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2015

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 5501015917 MI Primary

Addresses

Primary practice location

42955 Ford Rd
Canton, MI 48187-3377

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140522002204 MI Practitioner - Physical Therapist in Private Practice 9032332887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spine and Extremity Institute of South Lyon, L.L.C.Group PAC ID 3476742651, 9 clinicians

Practice addresses (Care Compare)

22180 Pontiac TRL
Suite E
South Lyon, MI 48178-9097
Phone (248) 446-0155

Merit-based Incentive Payment System (MIPS)

Final score
80.38 of 100Reported as group
Quality
80.41
Improvement activities
40
Cost
60.72

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501015917MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Spine and Extremity Institute of South Lyon, L.L.C. Physical Therapist CurrentSince Sep 28, 2020 Accepting new patients
Kinetic Rehabilitation Inc. Past Accepting new patients
Plymouth Physical Therapy Specialists Limited Partnership Physical Therapist PastSince Sep 28, 2020 Accepting new patients

Locations

22180 Pontiac Trl
South Lyon, MI 48178
Phone (248) 446-0155

22180 Pontiac Trl
Ste E
South Lyon, MI 48178
Phone (248) 446-0155

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": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420502400000",
    "number": "1346503786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42955 FORD RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481873377",
            "telephone_number": "734-981-2100",
            "fax_number": "734-981-2622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAWLOSKI",
        "first_name": "RENEE",
        "middle_name": "MARIE",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-20",
        "last_updated": "2015-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501015917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2015; 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.