Individual provider Active NPI

Michelle Roller

  • Physical Therapist
  • Ann Arbor, MI
National Provider Identifier
1497298434
Registry record updated Jan 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501010297 Issued in MI
Practice address
5840 Interface Dr Ste 400
Ann Arbor, MI 48103-9176
Phone
(734) 627-8001
NPI assigned
Nov 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2017

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 5501010297 MI Primary

Addresses

Primary practice location

5840 Interface Dr Ste 400
Ann Arbor, MI 48103-9176

Mailing address

5840 Interface Dr Ste 400
Ann Arbor, MI 48103-9176

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170228000904 MI Practitioner - Physical Therapist in Private Practice 2163706706 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5060 Jackson Rd
Suite D
Ann Arbor, MI 48103-1867
Phone (734) 627-8001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Life Skills Community Rehabilitation & Associates LLC Physical Therapist CurrentSince Feb 1, 2017 Accepting new patients
Life Skills Community Rehabilitation & Associates LLC CurrentSince Feb 1, 2017 Accepting new patients

Locations

5840 Interface Dr
Ste 400
Ann Arbor, MI 48103
Phone (734) 627-8001

5060 Jackson Rd
Ste D
Ann Arbor, MI 48103
Phone (734) 627-8001

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": "1479859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485216000000",
    "number": "1497298434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5840 INTERFACE DR STE 400",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481039176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5840 INTERFACE DR STE 400",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481039176",
            "telephone_number": "734-627-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLLER",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-23",
        "last_updated": "2017-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501010297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2017; 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.