Active NPI
Physical Therapy Healthcare Center, P.C.
- Physical Therapy Clinic/Center
- Shelby Township, MI
National Provider Identifier
1881924280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Clinic/Center
- License
- 5501005868
- Legal business name
- PHYSICAL THERAPY HEALTHCARE CENTER, P.C.
- Practice address
- 54750 Mound Rd
Shelby Township, MI 48316-1706 - Phone
- (586) 677-5574
- Fax
- (586) 677-5578
- NPI assigned
- Jan 6, 2010
- Last updated
- Jan 6, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Deepak A Sardey, PHYSICAL THERAPIST
- Title
- Rehab Director
- Phone
- (586) 677-5574
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | 5501005868 | MI | Primary |
Addresses
Primary practice location
54750 Mound Rd
Shelby Township, MI 48316-1706
Mailing address
54750 Mound Rd
Shelby Township, MI 48316-1706
Phone (586) 677-5574
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 650E05729 | Other | MI | BLUE CROSS BLUE SHIELD OF MICHIGAN |
| 4157105 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
54750 Mound Rd
Shelby Township, MI 48316
Phone (586) 677-5574
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Orthopedic Physical Therapist
- Shelby Township, MI
- NPI 1982765269
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1262736000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1262736000000",
"number": "1881924280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "54750 MOUND RD",
"city": "SHELBY TOWNSHIP",
"state": "MI",
"postal_code": "483161706",
"telephone_number": "586-677-5574",
"fax_number": "586-677-5578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "54750 MOUND RD",
"city": "SHELBY TOWNSHIP",
"state": "MI",
"postal_code": "483161706",
"telephone_number": "586-677-5574",
"fax_number": "586-677-5578"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PHYSICAL THERAPY HEALTHCARE CENTER, P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2010-01-06",
"last_updated": "2010-01-06",
"status": "A",
"authorized_official_last_name": "SARDEY",
"authorized_official_first_name": "DEEPAK",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "REHAB DIRECTOR",
"authorized_official_telephone_number": "586-677-5574",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "PHYSICAL THERAPIST"
},
"taxonomies": [
{
"code": "261QP2000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Physical Therapy",
"state": "MI",
"license": "5501005868",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD OF MICHIGAN",
"identifier": "650E05729",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4157105",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Shelby Township, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2010; 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.