Liesle Elsey, DPT
Individual provider Active NPI Physical Therapist · Novi, MI
NPI 1467723940 · NPPES record last updated Apr 24, 2024
Key facts
- NPI
- 1467723940
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 5501015804 (MI)
- Practice address
- 39575 W 10 Mile Rd Ste 201
Novi, MI 48375-2949 - Phone
- (248) 516-7250
- Fax
- (248) 516-7251
- NPI assigned
- Jan 16, 2012
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.73 of 100
- Quality
- 87.86
- Improvement activities
- 40
- Cost
- 61.36
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121026000728 | MI | Practitioner - Physical Therapist in Private Practice | 1456501493 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Agate Core Therapy LLC | Physical Therapist | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501015804 | MI | Yes |
Addresses
Primary practice location
39575 W 10 Mile Rd Ste 201
Novi, MI 48375-2949
Mailing address
33900 Harper Ave
Suite 104
Clinton Township, MI 48035-4258
Phone (586) 350-2644
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5501015804 | Other | MI | LICENSE |
Other names
- Liesle Travis
Other providers in Novi, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 24, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.