Individual provider Active NPI

Harish Sathri Jedediah, PT

  • Physical Therapist
  • Southgate, MI
National Provider Identifier
1467187690
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
12855 Dix Toledo Rd
Southgate, MI 48195-1744
Phone
(586) 219-1290
NPI assigned
Jul 21, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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 Primary

Addresses

Primary practice location

12855 Dix Toledo Rd
Southgate, MI 48195-1744

Mailing address

1595 Beachwood Dr
Walled Lake, MI 48390-5881
Phone (586) 219-1290

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230801001428 MI Practitioner - Physical Therapist in Private Practice 7315319514 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
A-Plus Home Health Care Inc. Current Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
A-Plus Home Health Care Inc.Southfield, MI, CCN 237552 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Corporate Officer (100%)
W-2 Managing Employee (100%)
Mar 4, 2025
Mar 4, 2025
Mar 4, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1467187690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1595 BEACHWOOD DR",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483905881",
            "telephone_number": "586-219-1290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12855 DIX TOLEDO RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481951744",
            "telephone_number": "586-219-1290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SATHRI JEDEDIAH",
        "first_name": "HARISH",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-21",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southgate, MI

Sources for this page

Verify at the official NPI Registry.