Individual provider Active NPI

Moiz Ali Bohra, PHYSICAL THERAPIST

  • Physical Therapist
  • Farmington Hills, MI
National Provider Identifier
1821003245
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501012211 Issued in MI
Practice address
24100 Drake Rd
Farmington Hills, MI 48335-3155
Phone
(647) 228-3050
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 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 5501012211 MI Primary

Addresses

Primary practice location

24100 Drake Rd
Farmington Hills, MI 48335-3155

Mailing address

24100 Drake Rd
Farmington Hills, MI 48335-3155
Phone (647) 228-3050

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160805001678 MI Practitioner - Physical Therapist in Private Practice 0345499521 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

24100 Drake Rd
Suite C
Farmington Hills, MI 48335-3155
Phone (248) 516-3960

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Forever Home Care LLC Current Accepting new patients
Significa Physical Therapy LLC Physical Therapist CurrentSince May 1, 2023 Accepting new patients

Locations

24100 Drake Rd
Farmington Hills, MI 48335
Phone (248) 471-5554

24100 Drake Rd
Ste C
Farmington Hills, MI 48335
Phone (248) 478-8880

39500 W 10 Mile Rd
Ste 109
Novi, MI 48375
Phone (248) 900-1927

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Forever Home Care LLCNovi, MI, CCN 239255 Home health agency Corporate Director
W-2 Managing Employee
May 31, 2023
May 31, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1821003245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24100 DRAKE RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483353155",
            "telephone_number": "647-228-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24100 DRAKE RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483353155",
            "telephone_number": "647-228-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHRA",
        "first_name": "MOIZ",
        "middle_name": "ALI",
        "name_prefix": "Mr.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501012211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.