Individual provider Active NPI

Jylian Pearl Randall, DPT

  • Orthopedic Physical Therapist
  • Troy, MI
National Provider Identifier
1366913691
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Practice address
3435 Livernois Rd
Troy, MI 48083-5063
Phone
(248) 353-1234
Fax
(248) 353-1211
NPI assigned
Dec 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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 Primary

Addresses

Primary practice location

3435 Livernois Rd
Troy, MI 48083-5063

Mailing address

1080 Kirts Blvd Ste 500
Troy, MI 48084-4882
Phone (248) 353-1234

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190205000416 MI Practitioner - Physical Therapist in Private Practice 2860730561 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Probility Therapy ServicesGroup PAC ID 6305897414, 106 clinicians

Practice addresses (Care Compare)

990 W Ann Arbor TRL
Suite 103
Plymouth, MI 48170-1686
Phone (734) 414-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ompt Specialists, Inc. Orthopedic CurrentSince Jan 17, 2019 Accepting new patients
Probility Therapy Services CurrentSince Mar 14, 2023 Accepting new patients
Probility Therapy Services Orthopedic CurrentSince Mar 14, 2023 Accepting new patients
Joseph Advanced Facial Plastic Surgery, PLLC PastSince Jul 14, 2024 Accepting new patients

Locations

990 W Ann Arbor Trl
Ste 103
Plymouth, MI 48170
Phone (734) 414-1000

1080 Kirts Blvd
Ste 500
Troy, MI 48084

3435 Livernois Rd
Troy, MI 48083
Phone (248) 743-1234

1080 Kirts Blvd
Ste 300
Troy, MI 48084

4600 Investment Dr
Ste 190
Troy, MI 48098
Phone (242) 353-1234

3145 W Clark Rd
Ste 102
Ypsilanti, MI 48197
Phone (734) 528-9760

3145 W Clark Rd
Ste 106
Ypsilanti, MI 48197
Phone (734) 528-9760

Organizations & group practices 4

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": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1366913691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 KIRTS BLVD STE 500",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480844882",
            "telephone_number": "248-353-1234",
            "fax_number": "248-353-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 LIVERNOIS RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480835063",
            "telephone_number": "248-353-1234",
            "fax_number": "248-353-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "JYLIAN",
        "middle_name": "PEARL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; 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.