NPIMap

Organization Active NPI

Waterworks Physical Therapy, PC

  • Physical Therapy Clinic/Center
  • Dearborn, MI
National Provider Identifier
1386133643
Registry record updated May 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
WATERWORKS PHYSICAL THERAPY, PC
Practice address
21031 Michigan Avenue
2ND Floor
Dearborn, MI 48124
Phone
(313) 216-0332
Fax
(313) 216-0335
NPI assigned
May 2, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2018

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

Authorized official

Name
Eric Silberg, M.D.NPI 1811959836
Title
General Partner
Phone
(313) 277-6700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

21031 Michigan Avenue
2ND Floor
Dearborn, MI 48124

Mailing address

21031 Michigan Avenue
2ND Floor
Dearborn, MI 48124
Phone (313) 216-0332

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190917000410 MI Part B Supplier - Clinic/Group Practice 8628307659 Receives reassigned benefits from 7 practitioners
Practice locations: Dearborn, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1525219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525219200000",
    "number": "1386133643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21031 MICHIGAN AVENUE",
            "address_2": "2ND FLOOR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "48124",
            "telephone_number": "313-216-0332",
            "fax_number": "313-216-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21031 MICHIGAN AVENUE",
            "address_2": "2ND FLOOR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "48124",
            "telephone_number": "313-216-0332",
            "fax_number": "313-216-0335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERWORKS PHYSICAL THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-02",
        "last_updated": "2018-05-02",
        "status": "A",
        "authorized_official_last_name": "SILBERG",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "GENERAL PARTNER",
        "authorized_official_telephone_number": "313-277-6700",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.