Individual provider Active NPI

Lydia Geraldine Vitale-Loeschner, MPT

  • Physical Therapist
  • Keego Harbor, MI
National Provider Identifier
1609887769
Registry record updated Jun 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501010481 Issued in MI
Practice address
2700 Orchard Lake Rd
Keego Harbor, MI 48320
Phone
(248) 683-0185
Fax
(248) 683-5692
NPI assigned
Aug 11, 2006
Last updated
Jun 13, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2014

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 5501010481 MI Primary

Addresses

Primary practice location

2700 Orchard Lake Rd
Keego Harbor, MI 48320

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140521000655 MI Practitioner - Physical Therapist in Private Practice 4981827938 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dearborn Physical Therapy LTDGroup PAC ID 2668383910, 97 clinicians
General Orthopedics PCGroup PAC ID 5294788261, 6 clinicians

Practice addresses (Care Compare)

1920 Livernois Rd
Suite C
Troy, MI 48083-1770
Phone (248) 362-2150

4800 Highland Rd
Waterford, MI 48328-1176
Phone (248) 673-0500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
General Orthopedics, PC Current Accepting new patients
General Orthopedics, PC CurrentSince Aug 14, 2025 Accepting new patients
Dearborn Physical Therapy LTD. Physical Therapist Current Accepting new patients
Dwight Orthopedic Rehabilitation Co Physical Therapist Past Accepting new patients
Hands on Physical Therapy Inc Physical Therapist Past Accepting new patients

Locations

23852 Michigan Ave
Dearborn, MI 48124
Phone (313) 565-4222

1920 Livernois Rd
Ste C
Troy, MI 48083
Phone (248) 362-2150

4800 Highland Rd
Waterford, MI 48328
Phone (248) 673-0500

Organizations & group practices 5

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": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402617600000",
    "number": "1609887769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 ORCHARD LAKE RD",
            "city": "KEEGO HARBOR",
            "state": "MI",
            "postal_code": "48320",
            "telephone_number": "248-683-0185",
            "fax_number": "248-683-5692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITALE-LOESCHNER",
        "first_name": "LYDIA",
        "middle_name": "GERALDINE",
        "name_prefix": "Mrs.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2014-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501010481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keego Harbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2014; 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.