Active NPI
Adam Kusmierczyk, PT
- Physical Therapist
- Macomb, MI
National Provider Identifier
1760954168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501005465
- Practice address
- 21322 Fairfield Dr
Macomb, MI 48044-2965 - Phone
- (586) 850-3941
- NPI assigned
- Dec 23, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501005465 | MI | Primary |
Addresses
Primary practice location
21322 Fairfield Dr
Macomb, MI 48044-2965
Mailing address
21322 Fairfield Dr
Macomb, MI 48044-2965
Phone (586) 850-3941
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501005465 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545523200000",
"number": "1760954168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21322 FAIRFIELD DR",
"city": "MACOMB",
"state": "MI",
"postal_code": "480442965",
"telephone_number": "586-850-3941"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21322 FAIRFIELD DR",
"city": "MACOMB",
"state": "MI",
"postal_code": "480442965",
"telephone_number": "586-850-3941"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUSMIERCZYK",
"first_name": "ADAM",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-12-23",
"last_updated": "2018-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501005465",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Macomb, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.