Individual provider Active NPI

Hetal U Vyas, PT

  • Physical Therapist
  • Livonia, MI
National Provider Identifier
1689925307
Registry record updated Apr 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501015136 Issued in MI
Practice address
17916 Farmington Rd
Livonia, MI 48152-3104
Phone
(248) 678-7021
NPI assigned
Sep 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2024

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 5501015136 MI Primary

Addresses

Primary practice location

17916 Farmington Rd
Livonia, MI 48152-3104

Mailing address

1509 Kensington Dr
Canton, MI 48188-3249
Phone (248) 678-7021

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210802000274 MI Practitioner - Physical Therapist in Private Practice 0042614844 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501015136MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthoprime Physical Therapy, LLC Physical Therapist CurrentSince Apr 11, 2024 Accepting new patients
Michigan Rehabilitation Specialists of Fowlerville LLC Physical Therapist CurrentSince Jul 12, 2021 Accepting new patients
Michigan Rehabilitation Specialists of Fowlerville, LLC CurrentSince Jul 12, 2021 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

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

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

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

17916 Farmington Rd
Livonia, MI 48152
Phone (734) 744-9236

11650 Belleville Rd
Ste 102
Van Buren Township, MI 48111
Phone (734) 325-2443

5210 Highland Rd
Ste 100
Waterford, MI 48327
Phone (248) 674-9560

23309 Allen Rd
Woodhaven, MI 48183
Phone (734) 561-0070

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1348099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712448000000",
    "number": "1689925307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 KENSINGTON DR",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481883249",
            "telephone_number": "248-678-7021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17916 FARMINGTON RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481523104",
            "telephone_number": "248-678-7021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VYAS",
        "first_name": "HETAL",
        "middle_name": "U",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-20",
        "last_updated": "2024-04-07",
        "certification_date": "2024-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501015136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2024; 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.

Verify at the official NPI Registry.