Active NPI
Move Detroit Fitness LLC
- Physical Therapy Clinic/Center
- Royal Oak, MI
National Provider Identifier
1639976996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Clinic/Center
- Legal business name
- MOVE DETROIT FITNESS LLC
- Practice address
- 4526 Fernlee Ave
Royal Oak, MI 48073-1782 - Phone
- (586) 255-7164
- NPI assigned
- Feb 25, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Alex Dusza, PT, DPT, TARS, TPI
- Title
- Physical Therapist / Co-Owner
- Phone
- (586) 255-7164
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | Primary |
Addresses
Primary practice location
4526 Fernlee Ave
Royal Oak, MI 48073-1782
Mailing address
4526 Fernlee Ave
Royal Oak, MI 48073-1782
Phone (586) 255-7164
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250607000092 | MI | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 9133646334 |
Receives reassigned benefits from 1 practitioner Practice locations: Royal Oak, MI |
National Provider Directory
National Provider DirectoryLocations
4526 Fernlee Ave
Royal Oak, MI 48073
Phone (586) 255-7164
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1740441600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1740441600000",
"number": "1639976996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4526 FERNLEE AVE",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480731782",
"telephone_number": "586-255-7164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4526 FERNLEE AVE",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480731782",
"telephone_number": "586-255-7164"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MOVE DETROIT FITNESS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-02-25",
"last_updated": "2025-02-25",
"certification_date": "2025-02-25",
"status": "A",
"authorized_official_last_name": "DUSZA",
"authorized_official_first_name": "ALEX",
"authorized_official_title_or_position": "PHYSICAL THERAPIST / CO-OWNER",
"authorized_official_telephone_number": "586-255-7164",
"authorized_official_credential": "PT, DPT, TARS, TPI"
},
"taxonomies": [
{
"code": "261QP2000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Physical Therapy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Royal Oak, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.