Individual provider Active NPI

Sarah Petlicki, PT, DPT

  • Physical Therapist
  • Troy, MI
National Provider Identifier
1922552868
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501017820 Issued in MI
Practice address
627 E Maple Rd
Suite 200
Troy, MI 48083-2812
Phone
(248) 524-1912
NPI assigned
Aug 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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 5501017820 MI Primary

Addresses

Primary practice location

627 E Maple Rd
Suite 200
Troy, MI 48083-2812

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180625003545 MI Practitioner - Physical Therapist in Private Practice 1355696758 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7715 26 Mile Rd
Washington, MI 48094-2804
Phone (586) 992-4930

Merit-based Incentive Payment System (MIPS)

Final score
85.78 of 100Reported as group
Quality
89.5
Improvement activities
40
Cost
71.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Rehabilitation Specialists of Fowlerville LLC Physical Therapist CurrentSince Jun 11, 2018 Accepting new patients
Michigan Rehabilitation Specialists of Fowlerville, LLC CurrentSince Jun 11, 2018 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

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

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

2510 S Telegraph Rd
Ste I
Bloomfield Hills, MI 48302
Phone (248) 335-2000

42615 Garfield Rd
Clinton Twp, MI 48038
Phone (586) 412-2845

43475 Dalcoma Dr
Clinton Twp, MI 48038
Phone (586) 263-5043

40097 S Groesbeck Hwy
Clinton Twp, MI 48036
Phone (586) 468-7612

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

12787 S Saginaw St
Ste C4
Grand Blanc, MI 48439
Phone (810) 771-7631

19169 Mack Ave
Grosse Pointe Woods, MI 48236
Phone (313) 308-0913

4950 S Baldwin Rd
Lake Orion, MI 48359
Phone (248) 409-0576

425 N Park Blvd
Ste 100
Lake Orion, MI 48362
Phone (248) 693-6835

1432 E 12 Mile Rd
Madison Hts, MI 48071
Phone (248) 543-4886

44200 Woodward Ave
Ste 114
Pontiac, MI 48341
Phone (248) 409-3300

2672 S Rochester Rd
Rochester Hills, MI 48307
Phone (248) 289-1785

31120 Gratiot Ave
Roseville, MI 48066
Phone (586) 541-2220

29275 Northwestern Hwy
Ste 150
Southfield, MI 48034
Phone (248) 351-6300

29900 Southfield Rd
Southfield, MI 48076
Phone (248) 663-0400

2215 18 Mile Rd
Sterling Heights, MI 48314
Phone (586) 930-0668

35724 Van Dyke Ave
Sterling Heights, MI 48312
Phone (586) 698-0081

1949 W Maple Rd
Troy, MI 48084
Phone (248) 268-5497

1350 Kirts Blvd
Ste 120
Troy, MI 48084
Phone (248) 244-7927

7715 26 Mile Rd
Washington Twp, MI 48094
Phone (248) 650-4601

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": "1470700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1922552868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627 E MAPLE RD",
            "address_2": "SUITE 200",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480832812",
            "telephone_number": "248-524-1912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETLICKI",
        "first_name": "SARAH",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-09",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501017820",
            "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 Apr 3, 2024; 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.