Individual provider Active NPI

Nicholas Alan Lefere

  • Physical Therapist
  • Plymouth, MI
National Provider Identifier
1720487069
Registry record updated Aug 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501016849 Issued in MI
Practice address
9368 N Lilley Rd
Plymouth, MI 48170-4610
Phone
(734) 416-3900
Fax
(734) 416-3903
NPI assigned
Aug 21, 2014
Last updated
Aug 21, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2014

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 5501016849 MI Primary

Addresses

Primary practice location

9368 N Lilley Rd
Plymouth, MI 48170-4610

Mailing address

9368 N Lilley Rd
Plymouth, MI 48170-4610
Phone (734) 416-3900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140924002453 MI Practitioner - Physical Therapist in Private Practice 1355561341 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

39885 Grand River Ave
Suite 300
Novi, MI 48375-2150
Phone (248) 615-0282

49650 Cherry Hill Rd
Suite 230
Canton, MI 48187-4860
Phone (734) 495-3725

6400 Telegraph Rd
Suite 1300
Bloomfield Hills, MI 48301-1722
Phone (248) 432-1934

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Plymouth Physical Therapy Specialists Limited Partnership Physical Therapist CurrentSince Aug 19, 2013 Accepting new patients
Plymouth Physical Therapy Specialists Limited Partnership Physical Therapist Past Accepting new patients

Locations

39885 Grand River Ave
Ste 300
Novi, MI 48375
Phone (248) 615-0282

9368 N Lilley Rd
Plymouth, MI 48170
Phone (734) 416-3900

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, 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": "1408579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408579200000",
    "number": "1720487069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9368 N LILLEY RD",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704610",
            "telephone_number": "734-416-3900",
            "fax_number": "734-416-3903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9368 N LILLEY RD",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704610",
            "telephone_number": "734-416-3900",
            "fax_number": "734-416-3903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEFERE",
        "first_name": "NICHOLAS",
        "middle_name": "ALAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-21",
        "last_updated": "2014-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501016849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2014; 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.