NPIMap

Individual provider Active NPI

Samir Hanna, PH.D. P.T.

  • Physical Therapist
  • Rochester, MI
National Provider Identifier
1750575486
Registry record updated Oct 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5507005736 Issued in MI
Practice address
1050 W University Dr Ste 3
Rochester, MI 48307-1877
Phone
(248) 650-1984
Fax
(248) 650-1994
NPI assigned
Sep 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2010

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 5507005736 MI Primary

Addresses

Primary practice location

1050 W University Dr Ste 3
Rochester, MI 48307-1877

Mailing address

5601 Aster Dr
Troy, MI 48085-3871
Phone (248) 650-1984

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110104000233 MI Practitioner - Physical Therapist in Private Practice 4789620303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marina Rehabilitation and Health Services IncGroup PAC ID 7618913237, 2 clinicians

Practice addresses (Care Compare)

1050 W University Dr
Suite 3
Rochester, MI 48307-1877
Phone (248) 650-1984

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
5507005736MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Marina Rehabilitation and Health Services, Inc. Physical Therapist CurrentSince Jun 25, 1997 Accepting new patients
Alpha Home Care, LLC PastSince May 4, 2010 Accepting new patients
Thomas DME, LLC PastSince May 2, 2011 Accepting new patients
St Mark Rehabilitation and Health Services PastSince May 3, 2004 Accepting new patients
Marina Rehabilitation and Health Services Past Accepting new patients

Locations

1050 W University Dr
Ste 3
Rochester, MI 48307
Phone (248) 650-1984

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Alpha Home Care LLCRochester, MI, CCN 239181 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Corporate Officer
Corporate Director
W-2 Managing Employee		 Jan 28, 2020
Jun 25, 2010
Jun 25, 2010
Jun 25, 2010

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Alpha Home Care, LLC
    • Home Health Agency
    • Rochester, MI
    • NPI 1194045344

    5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, W-2 Managing Employee

    CMS ownership

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": "1189036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287964800000",
    "number": "1750575486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 ASTER DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480853871",
            "telephone_number": "248-650-1984",
            "fax_number": "248-650-1994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 W UNIVERSITY DR STE 3",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483071877",
            "telephone_number": "248-650-1984",
            "fax_number": "248-650-1994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNA",
        "first_name": "SAMIR",
        "credential": "PH.D. P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-06",
        "last_updated": "2010-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5507005736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MI

Sources for this page

Verify at the official NPI Registry.