Individual provider Active NPI

Jaime Gendlin, DPT

  • Clinic/Center
  • Eastpointe, MI
National Provider Identifier
1891065538
Registry record updated Jan 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
5501015769 Issued in MI
Practice address
23411 Gratiot Ave
Eastpointe, MI 48021-1644
Phone
(248) 333-3335
Fax
(248) 333-0297
NPI assigned
Jan 11, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 5501015769 MI Primary

Addresses

Primary practice location

23411 Gratiot Ave
Eastpointe, MI 48021-1644

Mailing address

5688 Murphy CT
Warren, MI 48092-6336

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140314001347 MI Practitioner - Physical Therapist in Private Practice 3476784489 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Michigan Medical School, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Theramax Rehab IncGroup PAC ID 9739282278, 8 clinicians

Practice addresses (Care Compare)

2300 Grand Haven Dr
Troy, MI 48083-4418
Phone (586) 335-8182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501015769MIMDClinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Rehabilitation Specialists of Fowlerville, LLC CurrentSince Aug 23, 2021 Accepting new patients
Theramax Rehab, Inc Clinic/Center CurrentSince Aug 11, 2022 Accepting new patients
Michigan Rehabilitation Specialists of Fowlerville LLC Clinic/Center CurrentSince Aug 23, 2021 Accepting new patients
Theramatrix, Inc. Clinic/Center Past Accepting new patients
Theramatrix, Inc. Clinic/Center Past Accepting new patients

Locations

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

5700 Jackson Rd
Ann Arbor, MI 48103
Phone (734) 926-4710

10078 Lapeer Rd
Ste B
Davison, MI 48423
Phone (810) 653-6200

18760 E 13 Mile Rd
Roseville, MI 48066
Phone (586) 601-6119

5210 Highland Rd
Ste 100
Waterford, MI 48327
Phone (248) 674-9560

Organizations & group practices 5

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": "1326240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326240000000",
    "number": "1891065538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5688 MURPHY CT",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480926336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23411 GRATIOT AVE",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480211644",
            "telephone_number": "248-333-3335",
            "fax_number": "248-333-0297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENDLIN",
        "first_name": "JAIME",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-11",
        "last_updated": "2012-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MI",
            "license": "5501015769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eastpointe, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; 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.