Individual provider Active NPI

Gulshan Chandna

  • Occupational Therapist
  • Roseville, MI
National Provider Identifier
1376693473
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201005074 Issued in MI
Practice address
17255 Common Rd
Roseville, MI 48066-1954
Phone
(586) 335-8182
Fax
(248) 757-2330
NPI assigned
Jan 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5201005074 MI Primary

Addresses

Primary practice location

17255 Common Rd
Roseville, MI 48066-1954

Mailing address

3381 Hidden Oaks LN
West Bloomfield, MI 48324-3256
Phone (586) 335-8182

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051116000362 MI Practitioner - Occupational Therapist in Private Practice 9133148448 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Theramax Rehab IncGroup PAC ID 9739282278, 8 clinicians

Practice addresses (Care Compare)

2300 Grand Haven Dr
Troy, MI 48083-4418
Phone (586) 335-8182

36430 Van Dyke Ave
FL 3
Sterling Heights, MI 48312-2746
Phone (586) 335-8182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5201005074MIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Theramax Rehab, Inc Occupational Therapist CurrentSince Jan 1, 2007 Accepting new patients

Locations

18760 E 13 Mile Rd
Roseville, MI 48066
Phone (586) 601-6119

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": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1376693473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3381 HIDDEN OAKS LN",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483243256",
            "telephone_number": "586-335-8182",
            "fax_number": "248-757-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17255 COMMON RD",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480661954",
            "telephone_number": "586-335-8182",
            "fax_number": "248-757-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDNA",
        "first_name": "GULSHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201005074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.