NPIMap

Organization Active NPI

Medstar Rehabilitation Inc.

  • Physical Therapist
  • Canton, MI
National Provider Identifier
1720188584
Registry record updated May 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MEDSTAR REHABILITATION INC.
Practice address
2050 N. Haggerty Rd
Suite 280
Canton, MI 48187
Phone
(734) 844-0800
Fax
(734) 844-0808
NPI assigned
Sep 22, 2006
Last updated
May 5, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2014

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

Authorized official

Name
Meera Inder ThawaniNPI 1255471645
Title
President
Phone
(734) 844-0800

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)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

2050 N. Haggerty Rd
Suite 280
Canton, MI 48187

Mailing address

2050 N. Haggerty Rd
Suite 280
Canton, MI 48187
Phone (734) 844-0800

Other identifiers 3

IdentifierTypeStateIssuer
13468OtherMCARE
CK4098OtherRAILROAD MEDICARE
611600700OtherU.S. DEPARTMENT OF LABOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041005000254 MI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1456346683 Receives reassigned benefits from 3 practitioners
Practice locations: Canton, MI
O20160630001656 MI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1456346683 Receives reassigned benefits from 2 practitioners
Practice locations: Canton, MI

National Provider Directory

National Provider Directory

Locations

2050 N Haggerty Rd
Ste 280
Canton, MI 48187
Phone (734) 844-0800

41677 Ford Rd
#B
Canton, MI 48187
Phone (734) 844-0800

5141 Oakman Blvd
Dearborn, MI 48126
Phone (313) 359-8200

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399248000000",
    "number": "1720188584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 N. HAGGERTY RD",
            "address_2": "SUITE 280",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "48187",
            "telephone_number": "734-844-0800",
            "fax_number": "734-844-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 N. HAGGERTY RD",
            "address_2": "SUITE 280",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "48187",
            "telephone_number": "734-844-0800",
            "fax_number": "734-844-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSTAR REHABILITATION INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2014-05-05",
        "status": "A",
        "authorized_official_last_name": "THAWANI",
        "authorized_official_first_name": "MEERA",
        "authorized_official_middle_name": "INDER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-844-0800"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCARE",
            "identifier": "13468",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CK4098",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U.S. DEPARTMENT OF LABOR",
            "identifier": "611600700",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2014; 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.