Interstate Rehab Inc

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

INTERSTATE REHAB INC

Doing business as

Essenza Physical Therapy

Practice address

16910 W 10 Mile Rd Ste 101
Southfield, MI 48075-2920

Phone

(734) 341-8068

NPI assigned

Sep 8, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gerardo B. Carbonell, DPTNPI 1942544341

Title

Associate

Phone

(586) 530-7114

Specialties & licenses 1

Addresses

Other names 1

• Essenza Physical Therapy Doing business as

Tax ID family

Essenza Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Interstate Rehab

  dba Essenza Physical Therapy

  • Physical Therapy Clinic/Center
  • Troy, MI
  • NPI 1992578231
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gerardo B. Carbonell, PT, DPT

  • Physical Therapist
  • Troy, MI
  • NPI 1942544341
  NPD Authorized official

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

{
    "created_epoch": "1315440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698624000000",
    "number": "1629359369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16910 W 10 MILE RD STE 101",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752920",
            "telephone_number": "734-341-8068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16910 W 10 MILE RD STE 101",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752920",
            "telephone_number": "734-341-8068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERSTATE REHAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-08",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A",
        "authorized_official_last_name": "CARBONELL",
        "authorized_official_first_name": "GERARDO",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "ASSOCIATE",
        "authorized_official_telephone_number": "586-530-7114",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Essenza Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Essenza Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Interstate Home Health, LLC
• Intricate Care LLC
• Introspective Counseling, LLC
• Intuitive Touch Wellness Center
• Heather Marie Ionetz, M.A
• Iqbal Nasir, MD PC

• Physical Therapy Clinic/Center in Southfield, MI
• Providers in Southfield, MI by specialty
• Physical Therapy Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.