Individual provider Active NPI

Nicholas Shamoun, DPT

  • Physical Therapist
  • Macomb, MI
National Provider Identifier
1699131276
Registry record updated Jan 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501017535 Issued in MI
Practice address
23211 21 Mile Rd
Macomb, MI 48042-5184
Phone
(586) 231-0043
Fax
(586) 741-8953
NPI assigned
Jan 12, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2016

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 5501017535 MI Primary

Addresses

Primary practice location

23211 21 Mile Rd
Macomb, MI 48042-5184

Mailing address

1773 Star Batt Dr
Rochester Hills, MI 48309-3708
Phone (248) 650-4720

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160318002056 MI Practitioner - Physical Therapist in Private Practice 5395042378 Reassigns benefits to 10 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CKS of Mt Clemens LLCGroup PAC ID 0446321038, 17 clinicians

Practice addresses (Care Compare)

21550 Harrington St
Clinton Township, MI 48036-2362
Phone (586) 783-7590

47250 W 10 Mile Rd
Novi, MI 48374-2932
Phone (248) 938-0606

Merit-based Incentive Payment System (MIPS)

Final score
75.73 of 100Reported as group
Quality
81.02
Improvement activities
40
Cost
53.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
KSS of Shelby LLC CurrentSince Oct 28, 2016 Accepting new patients
Healthquest Physical Therapy and Wellness Center of Clarkston LLC Physical Therapist CurrentSince May 16, 2017 Accepting new patients
HQ of Oxford LLC Physical Therapist CurrentSince Oct 28, 2016 Accepting new patients
CKS of Mt Clemens LLC Physical Therapist CurrentSince Oct 28, 2016 Accepting new patients
Aks of Romeo LLC Physical Therapist CurrentSince Oct 28, 2016 Accepting new patients
Healthquest Physical Therapy and Wellness Center LLC Physical Therapist CurrentSince Oct 28, 2016 Accepting new patients
KKS of Michigan LLC CurrentSince Dec 17, 2016 Accepting new patients
HQ of Algonac LLC Physical Therapist CurrentSince Jan 1, 2019 Accepting new patients
KRS of Clawson LLC CurrentSince Oct 28, 2016 Accepting new patients
VMS of Macomb TWP LLC CurrentSince Jan 30, 2016 Accepting new patients
KSS of Shelby LLC Physical Therapist CurrentSince Oct 28, 2016 Accepting new patients
Trishard P.C. Past Accepting new patients

Locations

555 Saint Clair River Dr
Ste D
Algonac, MI 48001
Phone (810) 512-7474

555 Saint Clair River Dr
Algonac, MI 48001
Phone (810) 794-4917

32 S Main St
Clarkston, MI 48346
Phone (248) 922-9001

901 W Maple Rd
Clawson, MI 48017
Phone (248) 435-8230

21550 Harrington St
Ste D
Clinton Twp, MI 48036
Phone (586) 783-7590

411 W Nepessing St
Lapeer, MI 48446
Phone (810) 206-2200

22573 Hall Rd
Macomb, MI 48042
Phone (586) 231-0043

23211 21 Mile Rd
Macomb, MI 48042
Phone (586) 231-0043

3009 S Baldwin Rd
Orion, MI 48359
Phone (248) 393-7707

765 S Lapeer Rd
Oxford, MI 48371
Phone (248) 236-0035

2226 Crooks Rd
Rochester Hills, MI 48309
Phone (248) 289-3584

878 S Rochester Rd
Rochester Hills, MI 48307
Phone (248) 650-4404

1773 Star Batt Dr
Rochester Hills, MI 48309
Phone (248) 650-4720

67962 Van Dyke Rd
Romeo, MI 48065
Phone (586) 336-4022

48875 Hayes Rd
Shelby Township, MI 48315
Phone (586) 532-9602

29121 Northwestern Hwy
Southfield, MI 48034
Phone (248) 599-1166

29121 Northwestern Hwy
Ste A
Southfield, MI 48034
Phone (248) 599-1166

Organizations & group practices 12

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": "1452556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452556800000",
    "number": "1699131276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1773 STAR BATT DR",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483093708",
            "telephone_number": "248-650-4720",
            "fax_number": "248-650-8670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23211 21 MILE RD",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480425184",
            "telephone_number": "586-231-0043",
            "fax_number": "586-741-8953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMOUN",
        "first_name": "NICHOLAS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-12",
        "last_updated": "2016-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501017535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macomb, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2016; 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.