Individual provider Active NPI

Agnieszka Marzena Kusmierczyk

  • Massage Therapist
  • Southfield, MI
National Provider Identifier
1407498066
Registry record updated Oct 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
7501002186 Issued in MI
Practice address
24901 Northwestern Hwy Ste 101
Southfield, MI 48075-2200
Phone
(248) 358-3000
NPI assigned
Oct 15, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 7501002186 MI Primary

Addresses

Primary practice location

24901 Northwestern Hwy Ste 101
Southfield, MI 48075-2200

Mailing address

24901 Northwestern Hwy Ste 101
Southfield, MI 48075-2200
Phone (248) 358-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7501002186MIMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Neuromuscular Services, PLLC PastSince Oct 20, 2019 Accepting new patients
Rizwan Qadir MD PC PastSince Oct 20, 2019 Accepting new patients

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": "1571097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1407498066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24901 NORTHWESTERN HWY STE 101",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752200",
            "telephone_number": "248-358-3000",
            "fax_number": "248-358-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24901 NORTHWESTERN HWY STE 101",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752200",
            "telephone_number": "248-358-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSMIERCZYK",
        "first_name": "AGNIESZKA",
        "middle_name": "MARZENA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-15",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "7501002186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.