Organization Active NPI

Maxpro Rehab LLC

  • Occupational Therapist
  • Dearborn Heights, MI
National Provider Identifier
1740782275
Registry record updated Feb 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201005515 Issued in MI
Legal business name
MAXPRO REHAB LLC
Practice address
25210 Ford Rd
Dearborn Heights, MI 48127-4818
Phone
(313) 769-5354
Fax
(313) 769-5352
NPI assigned
Feb 28, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2018

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

Authorized official

Name
Mohamed Elhasan, OTRLNPI 1396247821
Title
President
Phone
(313) 769-5354

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
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X 5201005515 MI Primary

Addresses

Primary practice location

25210 Ford Rd
Dearborn Heights, MI 48127-4818

Mailing address

25210 Ford Rd
Dearborn Heights, MI 48127-4818
Phone (313) 769-5354

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180420001596 MI Part B Supplier - Clinic/Group Practice 9830452069 Receives reassigned benefits from 5 practitioners
Practice locations: Dearborn Heights, MI; Southgate, MI

National Provider Directory

National Provider Directory

Locations

13479 Northline Rd
Southgate, MI 48195
Phone (313) 663-6502

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1519776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519776000000",
    "number": "1740782275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25210 FORD RD",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481274818",
            "telephone_number": "313-769-5354",
            "fax_number": "313-769-5352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25210 FORD RD",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481274818",
            "telephone_number": "313-769-5354",
            "fax_number": "313-769-5352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXPRO REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-28",
        "last_updated": "2018-02-28",
        "status": "A",
        "authorized_official_last_name": "ELHASAN",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-769-5354",
        "authorized_official_credential": "OTRL"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201005515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2018; 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.