Individual provider Active NPI

Charmaine Bernardino Mayall, DPT

  • Physical Therapist
  • Rochester, MI
National Provider Identifier
1356864896
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501017825 Issued in MI
Practice address
910 Oakwood Dr Apt 177
Rochester, MI 48307-1372
Phone
(352) 391-7933
NPI assigned
Jul 17, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 5501017825 MI Primary

Addresses

Primary practice location

910 Oakwood Dr Apt 177
Rochester, MI 48307-1372

Mailing address

910 Oakwood Dr Apt 177
Rochester, MI 48307-1372
Phone (352) 391-7933

Other identifiers 1

IdentifierTypeStateIssuer
00Other00

Other names 1

  • Charmaine Domagas Bernardino Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171228001118 MI Practitioner - Physical Therapist in Private Practice 1052679859 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tmi East IncGroup PAC ID 3274864665, 62 clinicians

Practice addresses (Care Compare)

16351 Rotunda Dr
Dearborn, MI 48120-1170
Phone (810) 701-4633

851 Penniman Ave
Plymouth, MI 48170-1621

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501017825MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tmi East, Inc. CurrentSince Feb 7, 2025 Accepting new patients

Locations

851 Penniman Ave
Plymouth, MI 48170
Phone (248) 349-9595

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": "1500249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1356864896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 OAKWOOD DR APT 177",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483071372",
            "telephone_number": "352-391-7933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 OAKWOOD DR APT 177",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483071372",
            "telephone_number": "352-391-7933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYALL",
        "first_name": "CHARMAINE",
        "middle_name": "BERNARDINO",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501017825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "00",
            "identifier": "00",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARMAINE",
            "last_name": "BERNARDINO",
            "middle_name": "DOMAGAS",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rochester, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.