Lisa M Prusakiewicz, RPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501012731 Issued in MI

Practice address

44201 Dequindre Rd
Troy, MI 48085-1117

Phone

(248) 964-5000

NPI assigned

Jul 22, 2006

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

Other names 1

• Lisa M Edl Former name

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Metamora Physical Therapy LLCGroup PAC ID 5395004451, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Metamora Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Metamora, MI
  • NPI 1396257135
  Medicare reassignment Care Compare group
• Milton J Grosenbach Edd, PC

  • Psychologist
  • Metamora, MI
  • NPI 1821135831
  NPD

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579478400000",
    "number": "1437170529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5852 KIDDER RD",
            "city": "ALMONT",
            "state": "MI",
            "postal_code": "480039608",
            "telephone_number": "614-519-9061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44201 DEQUINDRE RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480851117",
            "telephone_number": "248-964-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2310 California Rd",
            "address_purpose": "LOCATION",
            "city": "Elkhart",
            "state": "IN",
            "postal_code": "465141228",
            "country_code": "US",
            "telephone_number": "574-264-0791",
            "fax_number": "574-970-1374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRUSAKIEWICZ",
        "first_name": "LISA",
        "middle_name": "M",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-22",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501012731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "EDL",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Protera Health Medical Group, P.C.
• Protera Health Medical of Michigan PC
• Protera Health, Inc
• Provision Home Care LLC
• Lindsay Prusakiewicz, FNP-C
• Jenna Haley Przeslawski
• Bradley Martin Przymusinski, LMSW
• Psychworks CSH
• Lauren M Puente, PA-C
• Joseph Pulito, DO

• Physical Therapist in Troy, MI
• Providers in Troy, 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 20, 2020; 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.