Individual provider Active NPI

Carol Mazurek, PT

  • Physical Therapist
  • Troy, MI
National Provider Identifier
1417387366
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501004105 Issued in MI
Practice address
75 W Square Lake Rd
Troy, MI 48098-2929
Phone
(248) 688-9010
Fax
(248) 688-9013
NPI assigned
Nov 13, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501004105 MI Primary

Addresses

Primary practice location

75 W Square Lake Rd
Troy, MI 48098-2929

Mailing address

33900 Harper Ave Ste 104
Clinton TWP, MI 48035-4258

Other names 1

  • Carol Yonka Former name

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Team Rehabilitation Services, LLC Physical Therapist CurrentSince Dec 12, 2024 Accepting new patients
Team Rehabilitation Services, LLC Physical Therapist CurrentSince Dec 12, 2024 Accepting new patients

Locations

16000 Southfield Rd
Allen Park, MI 48101
Phone (313) 359-8867

485 Columbia Ave E
Ste 10
Battle Creek, MI 49014
Phone (269) 719-8110

33900 Harper Ave
Ste 104
Clinton Twp, MI 48035
Phone (586) 416-9100

75 W Square Lake Rd
Troy, MI 48098
Phone (248) 688-9004

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": "1384300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1417387366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33900 HARPER AVE STE 104",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480354258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 W SQUARE LAKE RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480982929",
            "telephone_number": "248-688-9010",
            "fax_number": "248-688-9013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZUREK",
        "first_name": "CAROL",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-13",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501004105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "YONKA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Dec 17, 2024; 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.