Individual provider Active NPI

Diana Stanek

  • Physical Therapist
  • Burton, MI
National Provider Identifier
1447929971
Registry record updated Nov 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501020249 Issued in MI
Practice address
1096 S Belsay Rd
Burton, MI 48509-1948
Phone
(810) 743-1611
NPI assigned
Sep 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2021

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 5501020249 MI Primary

Addresses

Primary practice location

1096 S Belsay Rd
Burton, MI 48509-1948

Mailing address

1096 S Belsay Rd
Burton, MI 48509-1948
Phone (810) 743-1611

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210913000739 MI Practitioner - Physical Therapist in Private Practice 4587060868 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Medical Group GenesysGroup PAC ID 7214288281, 96 clinicians

Practice addresses (Care Compare)

1096 S Belsay Rd
Suite G
Burton, MI 48509-1948
Phone (810) 743-1611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501020249MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Medical Group Genesys Physical Therapist CurrentSince Dec 6, 2021 Accepting new patients
Fox Rehabilitation Services Mi LLC Physical Therapist CurrentSince Sep 8, 2021 Accepting new patients
Henry Ford Medical Group Genesys Current Accepting new patients
Genesys Integrated Group Practice PC Past Accepting new patients

Locations

2184 S Ballenger Hwy
Flint, MI 48503
Phone (810) 232-5627

1096 S Belsay Rd
Ste G
Flint, MI 48509
Phone (810) 743-1611

10785 S Saginaw St
Ste D
Grand Blanc, MI 48439
Phone (810) 695-6337

7 Carnegie Plz
Cherry Hill, NJ 08003

Organizations & group practices 5

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": "1631059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1447929971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1096 S BELSAY RD",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485091948",
            "telephone_number": "810-743-1611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1096 S BELSAY RD",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485091948",
            "telephone_number": "810-743-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANEK",
        "first_name": "DIANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-08",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501020249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; 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.