Individual provider Active NPI

Upen Dhirendrabhai Vyas

  • Physical Therapist
  • Livonia, MI
National Provider Identifier
1740594340
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501014471 Issued in MI
Practice address
17916 Farmington Rd
Livonia, MI 48152-3104
Phone
(734) 855-4046
Fax
(734) 469-4572
NPI assigned
Aug 6, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 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 5501014471 MI Primary

Addresses

Primary practice location

17916 Farmington Rd
Livonia, MI 48152-3104

Mailing address

17916 Farmington Rd
Livonia, MI 48152-3104
Phone (734) 855-4046

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101228000173 MI Practitioner - Physical Therapist in Private Practice 1557559010 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17916 Farmington Rd
Livonia, MI 48152-3104
Phone (734) 855-4046

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501014471MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Porretta Center for Orthopaedic Surgery, PLLC Physical Therapist CurrentSince Dec 16, 2021 Accepting new patients
Orthoprime Physical Therapy, LLC Physical Therapist CurrentSince Apr 18, 2025 Accepting new patients
The Porretta Center for Orthopaedic Surgery, PLLC CurrentSince Dec 16, 2021 Accepting new patients
Medical X-Ray Consultants, LTD Past Accepting new patients
Universal Health Group, Inc. Past Accepting new patients

Locations

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

22250 Providence Dr
Ste 401
Southfield, MI 48075
Phone (248) 349-7015

22250 Providence Dr
Ste 40
Southfield, MI 48075
Phone (248) 563-0306

Organizations & group practices 5

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": "1281052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1740594340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17916 FARMINGTON RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481523104",
            "telephone_number": "734-855-4046",
            "fax_number": "734-469-4572"
        },
        {
            "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": "734-855-4046",
            "fax_number": "734-469-4572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VYAS",
        "first_name": "UPEN",
        "middle_name": "DHIRENDRABHAI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-06",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501014471",
            "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 Aug 12, 2024; 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.