Miranda Rysiewicz, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501301903 Issued in MI

Practice address

30122 Harper Ave
Saint Clair Shores, MI 48082-1642

Phone

(586) 359-2487

Fax

(586) 359-2343

NPI assigned

Sep 7, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Michigan Medical School, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Plymouth Physical Therapy Specialists Limited PartnershipGroup PAC ID 3870488521, 65 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Plymouth Physical Therapy Specialists Limited Partnership

  • Physical Therapist
  • Northville, MI
  • NPI 1174626329
  Medicare reassignment Care Compare group NPD
• Plymouth Physical Therapy Specialists Limited Partnership

  • Physical Therapist
  • Saint Clair Shores, MI
  • NPI 1720672702
  NPD

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

{
    "created_epoch": "1662508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1407577661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9368 N LILLEY RD",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704610",
            "telephone_number": "586-359-2487",
            "fax_number": "586-359-2343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30122 HARPER AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480821642",
            "telephone_number": "586-359-2487",
            "fax_number": "586-359-2343"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35376 Van Dyke Ave",
            "address_purpose": "LOCATION",
            "city": "Sterling Heights",
            "state": "MI",
            "postal_code": "483123514",
            "country_code": "US",
            "telephone_number": "800-974-4378 x1890",
            "fax_number": "630-515-1536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYSIEWICZ",
        "first_name": "MIRANDA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-07",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501301903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea Rumohr
• Carey Ryan, PT
• Jane K Ryan, LMSW
• John A Ryan, PH.D.
• Mistie D Ryan
• Richard T Saady, LMT
• Davis Brian Sabo
• Sacred Heart Rehabilitation Center, Inc.
• Sacred Oak Counseling, P.L.L.C.
• Moutamn Sadoun, M.D.

• Physical Therapist in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.