Individual provider Active NPI

Paranthaman Sundaravaradan, PT

  • Physical Therapist
  • Wayne, MI
National Provider Identifier
1518016955
Registry record updated Oct 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501005636 Issued in MI
Practice address
33000 Annapolis St Ste 120
Wayne, MI 48184-2916
Phone
(734) 721-8785
Fax
(734) 721-2938
NPI assigned
Jan 8, 2007
Last updated
Oct 11, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 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 5501005636 MI Primary

Addresses

Primary practice location

33000 Annapolis St Ste 120
Wayne, MI 48184-2916

Mailing address

33000 Annapolis St Ste 120
Wayne, MI 48184-2916
Phone (734) 721-8785

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110302000985 MI Practitioner - Physical Therapist in Private Practice 3779765375 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kevin T. Crawford DO PCGroup PAC ID 3971588450, 2 clinicians

Practice addresses (Care Compare)

31535 Ford Rd
Garden City, MI 48135-1821
Phone (734) 721-8785

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501005636MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kevin T Crawford DO PC CurrentSince Dec 1, 2010 Accepting new patients
Functional Endocrinologist PLLC PastSince Mar 1, 2025 Accepting new patients
Medstar Rehabilitation Inc. Physical Therapist PastSince Jun 20, 2016 Accepting new patients

Locations

8722 Reliable Pkwy
Chicago, IL 60686

31535 Ford Rd
Garden City, MI 48135
Phone (313) 278-4540

33000 Annapolis St
Ste 120
Wayne, MI 48184
Phone (313) 721-8785

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507680000000",
    "number": "1518016955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33000 ANNAPOLIS ST STE 120",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481842916",
            "telephone_number": "734-721-8785",
            "fax_number": "734-721-2938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33000 ANNAPOLIS ST STE 120",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481842916",
            "telephone_number": "734-721-8785",
            "fax_number": "734-721-2938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDARAVARADAN",
        "first_name": "PARANTHAMAN",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2017-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501005636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.