Individual provider Active NPI

Susan E Taube, PT

  • Physical Therapist
  • Northville, MI
National Provider Identifier
1659499630
Registry record updated Jul 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501005858 Issued in MI
Practice address
215 E. Main Street Suite B
Northville, MI 48167-1681
Phone
(248) 349-9339
Fax
(248) 349-9342
NPI assigned
Mar 27, 2007
Last updated
Jul 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2020

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 5501005858 MI Primary

Addresses

Primary practice location

215 E. Main Street Suite B
Northville, MI 48167-1681

Mailing address

215 E. Main Street Suite B
Northville, MI 48167-1681
Phone (248) 349-9339

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081223000249 MI Practitioner - Physical Therapist in Private Practice 5991867103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proven Physical Therapy LLCGroup PAC ID 1456743418, 5 clinicians

Practice addresses (Care Compare)

145 E Cady St
Northville, MI 48167-1606
Phone (248) 773-7540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501005858MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Proven Physical Therapy LLC CurrentSince Jun 12, 2023 Accepting new patients
Northville Physical Rehabilitation, P.C. Physical Therapist CurrentSince Nov 11, 2019 Accepting new patients

Locations

145 E Cady St
Northville, MI 48167
Phone (248) 719-5712

215 E Main St
Ste B
Northville, MI 48167
Phone (248) 349-9339

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": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594252800000",
    "number": "1659499630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E. MAIN STREET SUITE B",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481671681",
            "telephone_number": "248-349-9339",
            "fax_number": "248-349-9342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E. MAIN STREET SUITE B",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481671681",
            "telephone_number": "248-349-9339",
            "fax_number": "248-349-9342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAUBE",
        "first_name": "SUSAN",
        "middle_name": "E",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501005858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2020; 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.