Active NPI
Amanda Woodruff
- Physical Therapist
- Royal Oak, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501301994
- Practice address
- 29480 Woodward Ave
Royal Oak, MI 48073-0903 - Phone
- (248) 541-9121
- Fax
- (248) 541-8386
- NPI assigned
- Jul 12, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | |||
| Physical Therapist | 225100000X | 5501301994 | MI | Primary |
Addresses
Primary practice location
29480 Woodward Ave
Royal Oak, MI 48073-0903
Mailing address
2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-6250
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
29480 Woodward Ave
Royal Oak, MI 48073-0903
Phone (248) 541-9121
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.32 of 100
- Quality
- 84.44
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 70.78
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501301994 | MI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Athletico LTD | Physical Therapist | Current | Accepting new patients |
| Athletico LTD | Physical Therapist | Current | Accepting new patients |
Locations
2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250
1801 W Maumee St
Ste 125
Adrian, MI 49221
Phone (517) 264-6141
2570 Jackson Ave
Ste C
Ann Arbor, MI 48103
Phone (734) 823-7820
29480 Woodward Ave
Royal Oak, MI 48073
Phone (248) 541-8386
Interoperability endpoints
- amanda.woodruff.p4@direct.athleticoltd.nextgenshare.com
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": "1468281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669593600000",
"number": "1912359191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2122 YORK RD STE 300",
"city": "OAK BROOK",
"state": "IL",
"postal_code": "605231925",
"telephone_number": "630-575-6250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29480 WOODWARD AVE",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480730903",
"telephone_number": "248-541-9121",
"fax_number": "248-541-8386"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODRUFF",
"first_name": "AMANDA",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-12",
"last_updated": "2022-11-28",
"certification_date": "2022-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501301994",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Royal Oak, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2022; 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.