Individual provider Active NPI

Matthew T Lizza, OTR/L

  • Occupational Therapist
  • Farmington Hills, MI
National Provider Identifier
1710655899
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201011220 Issued in MI
Practice address
27655 Middlebelt Rd Ste 130
Farmington Hills, MI 48334-5029
Phone
(248) 318-7912
NPI assigned
Sep 2, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5201011220 MI Primary

Addresses

Primary practice location

27655 Middlebelt Rd Ste 130
Farmington Hills, MI 48334-5029

Mailing address

27655 Middlebelt Rd Ste 130
Farmington Hills, MI 48334-5029
Phone (248) 318-7912

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250211002832 GA Practitioner - Occupational Therapist in Private Practice 2567869183 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5201011220MIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bolanos Associates, LLC. Occupational Therapist CurrentSince Feb 14, 2024 Accepting new patients
Human Performance and Rehabilitation Centers, LLC Occupational Therapist Current Accepting new patients
Human Performance and Rehabilitation Centers LLC CurrentSince Nov 30, 2024 Accepting new patients
Human Performance and Rehabilitation Centers, LLC CurrentSince Nov 30, 2024 Accepting new patients

Locations

4801 S University Dr
Ste 101
Davie, FL 33328
Phone (786) 259-0300

13335 SW 124th St
Ste 202
Miami, FL 33186
Phone (786) 259-0300

1150 NW 72nd Ave
Ste 720
Miami, FL 33126
Phone (305) 599-1990

7340 NW 5th St
Plantation, FL 33317
Phone (786) 259-0300

15751 Sheridan St
Southwest Ranches, FL 33331
Phone (786) 877-2039

788 Prince Ave
Ste C
Athens, GA 30606
Phone (706) 453-2111

6298 Veterans Pkwy
Ste 5A
Columbus, GA 31909
Phone (706) 320-0927

6801 River Rd
Ste 302
Columbus, GA 31904
Phone (706) 507-3349

6298 Veterans Pkwy
Ste 5B
Columbus, GA 31909
Phone (706) 225-0380

2515 Double Churches Rd
Ste 300
Columbus, GA 31909

1157 West Ave SW
#B
Conyers, GA 30012
Phone (770) 922-2120

1883 McDonough Rd
Ste C
Lovejoy, GA 30228
Phone (760) 219-4631

909 Eagles Landing Pkwy
Ste 430
Stockbridge, GA 30281
Phone (770) 506-6993

1650 Lyndon Farm Ct
Ste 300
Louisville, KY 40223
Phone (726) 202-3039

Organizations & group practices 4

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": "1630540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1710655899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27655 MIDDLEBELT RD STE 130",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483345029",
            "telephone_number": "248-318-7912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27655 MIDDLEBELT RD STE 130",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483345029",
            "telephone_number": "248-318-7912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIZZA",
        "first_name": "MATTHEW",
        "middle_name": "T",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-02",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201011220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; 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.