Organization Active NPI

Divine Institute of Rehabilitation Inc

  • Physical Medicine & Rehabilitation Physician
  • Madison Heights, MI
National Provider Identifier
1972015253
Registry record updated Oct 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
07026N Issued in MI
Legal business name
DIVINE INSTITUTE OF REHABILITATION INC
Practice address
28157 Dequindre Rd Ste a
Madison Heights, MI 48071-3046
Phone
(248) 470-1753
Fax
(586) 314-0525
NPI assigned
Oct 26, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2017

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

Authorized official

Name
Mrs. Ripal Patel, P.T.
Title
Owner
Phone
(248) 470-1753

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X 07026N MI Primary

Addresses

Primary practice location

28157 Dequindre Rd Ste a
Madison Heights, MI 48071-3046

Mailing address

28157 Dequindre Rd Ste a
Madison Heights, MI 48071-3046
Phone (248) 470-1753

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230522001971 MI Part B Supplier - Clinic/Group Practice 7315303138 Receives reassigned benefits from 2 practitioners
Practice locations: Madison Heights, MI

National Provider Directory

National Provider Directory

Locations

16250 Northland Dr
Ste 303
Southfield, MI 48075
Phone (313) 427-6386

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1508976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508976000000",
    "number": "1972015253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28157 DEQUINDRE RD STE A",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480713046",
            "telephone_number": "248-470-1753",
            "fax_number": "586-314-0525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28157 DEQUINDRE RD STE A",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480713046",
            "telephone_number": "248-470-1753",
            "fax_number": "586-314-0525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE INSTITUTE OF REHABILITATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-26",
        "last_updated": "2017-10-26",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "RIPAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-470-1753",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "07026N",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2017; 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.

Verify at the official NPI Registry.