Individual provider Active NPI

Michelle Pavlish, PT

  • Physical Therapist
  • Traverse City, MI
National Provider Identifier
1538411467
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501016092 Issued in MI
Practice address
1110 Hammond Rd E Unit 5
Traverse City, MI 49686-9368
Phone
(231) 995-5210
NPI assigned
Oct 2, 2012
Last updated
Apr 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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 5501016092 MI Primary

Addresses

Primary practice location

1110 Hammond Rd E Unit 5
Traverse City, MI 49686-9368

Mailing address

2001 Butterfield Rd Ste 1600
Downers Grove, IL 60515-1211
Phone (866) 370-8206

Other practice location 1

1650 Barlow St
Traverse City, MI 49686-4721
Phone (231) 941-3100

Other identifiers 1

IdentifierTypeStateIssuer
43-2035142OtherMITAX ID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121204000455 MI Practitioner - Physical Therapist in Private Practice 8527210277 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1110 E Hammond Dr
5 Ati Physical Therapy
Traverse City, MI 49686-9368
Phone (231) 995-5210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Rehabilitation Specialists of Fowlerville, LLC CurrentSince Apr 28, 2025 Accepting new patients
Michigan Rehabilitation Specialists of Fowlerville LLC Physical Therapist CurrentSince Apr 28, 2025 Accepting new patients

Locations

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

2001 Butterfield Rd
Ste 1600
Downers Grove, IL 60515

5700 Jackson Rd
Ann Arbor, MI 48103
Phone (734) 926-4710

10078 Lapeer Rd
Ste B
Davison, MI 48423
Phone (810) 653-6200

1110 E Hammond Rd
Unit 5
Traverse City, MI 49686
Phone (231) 995-5210

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, 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": "1349136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1538411467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211",
            "telephone_number": "866-370-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 HAMMOND RD E UNIT 5",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496869368",
            "telephone_number": "231-995-5210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1650 Barlow St",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496864721",
            "country_code": "US",
            "telephone_number": "231-941-3100",
            "fax_number": "231-941-8812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAVLISH",
        "first_name": "MICHELLE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-02",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501016092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "43-2035142",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2025; 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.