Individual provider Active NPI

Paul R Bar, PT

  • Physical Therapist
  • Dearborn, MI
National Provider Identifier
1790740264
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501012431 Issued in MI
Practice address
21031 Michigan Ave
Dearborn, MI 48124-2339
Phone
(313) 216-0332
Fax
(313) 216-0335
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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 5501012431 MI Primary

Addresses

Primary practice location

21031 Michigan Ave
Dearborn, MI 48124-2339

Mailing address

33900 Harper Ave Ste 104
Clinton TWP, MI 48035-4258
Phone (586) 350-2644

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120522001089 MI Practitioner - Physical Therapist in Private Practice 7315100781 Reassigns benefits to 6 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Milia-Waterworks PC CurrentSince Aug 21, 2015 Accepting new patients
Brossy-Waterworks PC Physical Therapist CurrentSince Jan 28, 2020 Accepting new patients
Finch-Waterworks PC CurrentSince Apr 28, 2020 Accepting new patients
Waterworks Physical Therapy, PC CurrentSince Aug 12, 2019 Accepting new patients
Patel-Waterworks PC CurrentSince Jan 9, 2012 Accepting new patients
Saad-Waterworks, PC Physical Therapist CurrentSince Feb 25, 2016 Accepting new patients

Locations

21031 Michigan Ave
#2
Dearborn, MI 48124

21031 Michigan Ave
Dearborn, MI 48124
Phone (313) 216-0332

21031 Michigan Ave
Fl 2
Dearborn, MI 48124
Phone (313) 216-0332

Organizations & group practices 6

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": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1790740264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33900 HARPER AVE STE 104",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480354258",
            "telephone_number": "586-350-2644",
            "fax_number": "586-541-3735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21031 MICHIGAN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242339",
            "telephone_number": "313-216-0332",
            "fax_number": "313-216-0335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAR",
        "first_name": "PAUL",
        "middle_name": "R",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501012431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; 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.