Individual provider Active NPI

Shelby Antoinette Frolek, DPT

  • Orthopedic Physical Therapist
  • Livonia, MI
National Provider Identifier
1366084030
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
5501019263 Issued in MI
Practice address
36622 Five Mile Rd Ste 102
Livonia, MI 48154-1900
Phone
(734) 542-9770
Fax
(734) 542-9790
NPI assigned
Oct 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 5501019263 MI Primary

Addresses

Primary practice location

36622 Five Mile Rd Ste 102
Livonia, MI 48154-1900

Mailing address

27472 Schoenherr Rd Ste 130
Warren, MI 48088-6675
Phone (586) 439-6243

Other names 1

  • Shelby Antoinette Gusfa Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191119001869 MI Practitioner - Physical Therapist in Private Practice 9032541750 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Golan Integrated Physical MedicineGroup PAC ID 2365678125, 16 clinicians

Practice addresses (Care Compare)

3097 29TH St SE
Suite B
Grand Rapids, MI 49512-1726
Phone (616) 741-2232

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Golan Integrated Physical Medicine CurrentSince Feb 28, 2025 Accepting new patients
Golan Integrated Physical Medicine CurrentSince Feb 28, 2025 Accepting new patients

Locations

3097 29th St SE
Ste B
Grand Rapids, MI 49512
Phone (616) 741-2232

Organizations & group practices 2

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": "1571011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1366084030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27472 SCHOENHERR RD STE 130",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480886675",
            "telephone_number": "586-439-6243",
            "fax_number": "586-439-6240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36622 FIVE MILE RD STE 102",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481541900",
            "telephone_number": "734-542-9770",
            "fax_number": "734-542-9790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FROLEK",
        "first_name": "SHELBY",
        "middle_name": "ANTOINETTE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-14",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MI",
            "license": "5501019263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELBY",
            "last_name": "GUSFA",
            "middle_name": "ANTOINETTE",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2025; 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.