Individual provider Active NPI

Ujjwal Kumar

  • Physical Therapist
  • Troy, MI
National Provider Identifier
1811467913
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501013843 Issued in MI
Practice address
1663 Stephenson Hwy
Troy, MI 48083-2169
Phone
(248) 327-6619
NPI assigned
Nov 30, 2018
Last updated
May 19, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 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 5501013843 MI Primary

Addresses

Primary practice location

1663 Stephenson Hwy
Troy, MI 48083-2169

Mailing address

38421 San Valleluce Dr
Sterling Heights, MI 48312-1272
Phone (248) 705-0883

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230915002227 MI Practitioner - Physical Therapist in Private Practice 0749646354 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501013843MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-Care Physical Therapy LLC Single Specialty CurrentSince Jul 31, 2023 Accepting new patients

Locations

24100 W Warren St
Dearborn Heights, MI 48127
Phone (313) 334-1116

Interoperability endpoints

  • Direct secure messaging: uujwal.kumar.1@24522.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1543536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1811467913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38421 SAN VALLELUCE DR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483121272",
            "telephone_number": "248-705-0883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1663 STEPHENSON HWY",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480832169",
            "telephone_number": "248-327-6619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "UJJWAL",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-30",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501013843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.