Individual provider Active NPI

Alibeth Ann Andresmercado

  • Physical Therapist
  • West Bloomfield, MI
National Provider Identifier
1770053522
Registry record updated Dec 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501011564 Issued in MI
Practice address
3936 W Newland Dr
West Bloomfield, MI 48323-3109
Phone
(248) 722-9179
NPI assigned
Dec 4, 2018
Sex
Female
Sole proprietor
Yes

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

LicenseStateTypeSpecialty
5501011564MIMDPhysical Therapist

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501011564 MI Primary

Addresses

NPPES NPI Registry

Primary practice location

3936 W Newland Dr
West Bloomfield, MI 48323-3109

Mailing address

3936 W Newland Dr
West Bloomfield, MI 48323-3109
Phone (248) 722-9179

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 4, 2018.

{
    "created_epoch": "1543881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543881600000",
    "number": "1770053522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3936 W NEWLAND DR",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483233109",
            "telephone_number": "248-722-9179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3936 W NEWLAND DR",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483233109",
            "telephone_number": "248-722-9179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRESMERCADO",
        "first_name": "ALIBETH",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-04",
        "last_updated": "2018-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501011564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.

Verify at the official NPI Registry.