Active NPI
Susan R Grabowski, DO
- Physical Medicine & Rehabilitation Physician
- Grosse Pointe Farms, MI
National Provider Identifier
1962427377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 5101014996
- Practice address
- 18530 Mack Ave
Suite 411
Grosse Pointe Farms, MI 48236-3254 - Phone
- (313) 655-4824
- Fax
- (313) 886-3910
- NPI assigned
- Jul 13, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 5101014996 | MI | Primary |
Addresses
Primary practice location
18530 Mack Ave
Suite 411
Grosse Pointe Farms, MI 48236-3254
Mailing address
18530 Mack Ave
Suite 411
Grosse Pointe Farms, MI 48236-3254
Phone (313) 655-4824
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2555012374 | Other | MI | BCBS PIN |
| 2558217654 | Other | MI | BS PIN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 1, 2021 through Jul 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101014996 | MI | MD | Physical Medicine & Rehabilitation Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282521600000",
"number": "1962427377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18530 MACK AVE",
"address_2": "SUITE 411",
"city": "GROSSE POINTE FARMS",
"state": "MI",
"postal_code": "482363254",
"telephone_number": "313-655-4824",
"fax_number": "313-886-3910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18530 MACK AVE",
"address_2": "SUITE 411",
"city": "GROSSE POINTE FARMS",
"state": "MI",
"postal_code": "482363254",
"telephone_number": "313-655-4824",
"fax_number": "313-886-3910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRABOWSKI",
"first_name": "SUSAN",
"middle_name": "R",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-13",
"last_updated": "2010-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "MI",
"license": "5101014996",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PIN",
"identifier": "2555012374",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BS PIN",
"identifier": "2558217654",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grosse Pointe Farms, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.