Active NPI
Sanjay Uppal, P.T, MHS
- Physical Therapist
- Southfield, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501004980
- Practice address
- 26771 W 12 Mile Rd
Suite # 103
Southfield, MI 48034-1539 - Phone
- (248) 945-9905
- Fax
- (248) 945-9906
- NPI assigned
- Mar 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501004980 | MI | Primary |
Addresses
Primary practice location
26771 W 12 Mile Rd
Suite # 103
Southfield, MI 48034-1539
Mailing address
6571 Shadowood Dr
West Bloomfield, MI 48322-3295
Phone (248) 895-1320
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
26771 W 12 Mile Rd
Southfield, MI 48034-1539
Phone (248) 945-9905
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501004980 | MI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeast Rehabilitation and Physical Therapy Inc. | Physical Therapist | Current | Accepting new patients |
Locations
26771 W 12 Mile Rd
Ste 103
Southfield, MI 48034
Phone (248) 945-9905
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.
| Facility | Type | Role | Since |
|---|---|---|---|
| Southeast Home Health Care, L.L.C | Home health agency | 5% Or Greater Direct Ownership Interest (50%) Corporate Officer (50%) Corporate Director (50%) W-2 Managing Employee |
Sep 18, 2007 Sep 18, 2007 Sep 18, 2007 Sep 18, 2007 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Home Health Agency
- Southfield, MI
- NPI 1891979779
5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, W-2 Managing Employee
Organizations & group practices 1
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.
-
dba Southeast Rehabilitation
- Physical Therapist
- Southfield, MI
- NPI 1306048210
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1286928000000",
"number": "1508827544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6571 SHADOWOOD DR",
"city": "WEST BLOOMFIELD",
"state": "MI",
"postal_code": "483223295",
"telephone_number": "248-895-1320",
"fax_number": "248-945-9906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26771 W 12 MILE RD",
"address_2": "SUITE # 103",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480341539",
"telephone_number": "248-945-9905",
"fax_number": "248-945-9906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UPPAL",
"first_name": "SANJAY",
"name_prefix": "Mr.",
"credential": "P.T, MHS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-29",
"last_updated": "2010-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501004980",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- 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.