Individual provider Active NPI

Nicole Marie Robideau, DPT

  • Physical Therapist
  • Clinton Township, MI
National Provider Identifier
1467775148
Registry record updated Oct 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501015088 Issued in MI
Practice address
21550 Harrington St
Suite D
Clinton Township, MI 48036-2362
Phone
(586) 783-7590
Fax
(586) 783-7876
NPI assigned
Mar 9, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 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 5501015088 MI Primary

Addresses

Primary practice location

21550 Harrington St
Suite D
Clinton Township, MI 48036-2362

Mailing address

1773 Star Batt Dr
Rochester Hills, MI 48309-3708
Phone (248) 601-9207

Other identifiers 1

IdentifierTypeStateIssuer
650E031120OtherMIBCBSM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100526000504 MI Practitioner - Physical Therapist in Private Practice 7012046287 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CKS of Mt Clemens LLCGroup PAC ID 0446321038, 17 clinicians

Practice addresses (Care Compare)

21550 Harrington St
Clinton Township, MI 48036-2362
Phone (586) 783-7590

32155 23 Mile Rd
Chesterfield, MI 48047-1986
Phone (586) 713-5590

Merit-based Incentive Payment System (MIPS)

Final score
75.73 of 100Reported as group
Quality
81.02
Improvement activities
40
Cost
53.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
VMS of Macomb TWP LLC CurrentSince Dec 11, 2017 Accepting new patients
HQ of Algonac LLC Physical Therapist CurrentSince Jun 25, 2018 Accepting new patients
CKS of Mt Clemens LLC Physical Therapist CurrentSince Mar 12, 2010 Accepting new patients
Trishard P.C. Past Accepting new patients

Locations

555 Saint Clair River Dr
Ste D
Algonac, MI 48001
Phone (810) 512-7474

21550 Harrington St
Ste D
Clinton Twp, MI 48036
Phone (586) 783-7590

22573 Hall Rd
Macomb, MI 48042
Phone (586) 231-0043

878 S Rochester Rd
Rochester Hills, MI 48307
Phone (248) 650-4404

1773 Star Batt Dr
Rochester Hills, MI 48309
Phone (248) 650-4720

Organizations & group practices 4

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": "1268092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1467775148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1773 STAR BATT DR",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483093708",
            "telephone_number": "248-601-9207",
            "fax_number": "248-650-8670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21550 HARRINGTON ST",
            "address_2": "SUITE D",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480362362",
            "telephone_number": "586-783-7590",
            "fax_number": "586-783-7876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBIDEAU",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-09",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501015088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "650E031120",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.