Individual provider Active NPI

Brittany M Delisle, P.T.

  • Physical Therapist
  • Brighton, MI
National Provider Identifier
1770514036
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501019770 Issued in MI
Practice address
2305 Genoa Business Park Dr Ste 170
Brighton, MI 48114-7005
Phone
(810) 299-8557
Fax
(810) 844-0837
NPI assigned
Jul 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 027524 NY
Physical Therapist 225100000X 5501019770 MI Primary

Addresses

Primary practice location

2305 Genoa Business Park Dr Ste 170
Brighton, MI 48114-7005

Mailing address

2305 Genoa Business Park Dr Ste 170
Brighton, MI 48114-7005
Phone (810) 299-8557

Other identifiers 1

IdentifierTypeStateIssuer
694693OtherNYACN PROVIDER ID NUMBER

Other names 1

  • Brittany M Lyon Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210603002822 MI Practitioner - Physical Therapist in Private Practice 5597869958 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Orthopedic Specialists, PCGroup PAC ID 4981697976, 11 clinicians

Practice addresses (Care Compare)

2305 Genoa Business Park Dr
Suite 170
Brighton, MI 48114-7005
Phone (810) 299-8550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
027524NYMDPediatric Dentist
5501019770MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Orthopedic Specialists PC CurrentSince Aug 26, 2024 Accepting new patients
Pro-Motion Physical Therapy, PLLC Physical Therapist CurrentSince May 24, 2021 Accepting new patients
Advanced Orthopedic Specialists PC PastSince Aug 11, 2024 Accepting new patients

Locations

205 W Grand River Ave
Brighton, MI 48116
Phone (248) 220-4499

205 W Grand River Ave
Ste 201
Brighton, MI 48116
Phone (810) 588-4133

2305 Genoa Business Park Dr
Ste 170
Brighton, MI 48114
Phone (810) 299-8550

Organizations & group practices 3

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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1770514036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2305 GENOA BUSINESS PARK DR STE 170",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481147005",
            "telephone_number": "810-299-8557",
            "fax_number": "810-844-0837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 GENOA BUSINESS PARK DR STE 170",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481147005",
            "telephone_number": "810-299-8557",
            "fax_number": "810-844-0837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELISLE",
        "first_name": "BRITTANY",
        "middle_name": "M",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "027524",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501019770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN PROVIDER ID NUMBER",
            "identifier": "694693",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRITTANY",
            "last_name": "LYON",
            "middle_name": "M",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brighton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.