Individual provider Active NPI

Aaron Wienczak, OTR

  • Hand Occupational Therapist
  • Livonia, MI
National Provider Identifier
1972166692
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
5201010574 Issued in MI
Practice address
36622 Five Mile Rd Ste 215
Livonia, MI 48154-1900
Phone
(734) 542-9770
NPI assigned
Apr 18, 2019
Last updated
Jun 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X 5201010574 MI Primary

Addresses

Primary practice location

36622 Five Mile Rd Ste 215
Livonia, MI 48154-1900

Mailing address

36622 Five Mile Rd Ste 102
Livonia, MI 48154-1900
Phone (734) 542-9770

Other practice location 1

27472 Schoenherr Rd Ste 130
Warren, MI 48088-6675
Phone (586) 439-6243

Other identifiers 1

IdentifierTypeStateIssuer
5201010574OtherMISTATE LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190506002156 MI Practitioner - Occupational Therapist in Private Practice 5597007807 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Wayne State University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mendelson Orthopedics PCGroup PAC ID 8426008368, 69 clinicians

Practice addresses (Care Compare)

36622 5 Mile Rd
Livonia, MI 48154-1900
Phone (734) 542-0200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5201010574MIMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mendelson Orthopedics PC CurrentSince Apr 29, 2019 Accepting new patients
Mendelson Orthopedics PC CurrentSince Apr 29, 2019 Accepting new patients
Mendelson Orthopedics PC Current Accepting new patients

Locations

7684 Solutions Ctr
#777684
Chicago, IL 60677

14555 Levan Rd
Ste 215
Livonia, MI 48154
Phone (734) 542-0200

36622 5 Mile Rd
Livonia, MI 48154
Phone (734) 542-0200

36622 5 Mile Rd
Ste 102
Livonia, MI 48154
Phone (734) 542-9770

36622 5 Mile Rd
Ste 215
Livonia, MI 48154
Phone (734) 542-9770

27472 Schoenherr Rd
Ste 130
Warren, MI 48088
Phone (586) 439-6243

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1972166692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36622 FIVE MILE RD STE 102",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481541900",
            "telephone_number": "734-542-9770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36622 FIVE MILE RD STE 215",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481541900",
            "telephone_number": "734-542-9770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27472 Schoenherr Rd Ste 130",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "MI",
            "postal_code": "480886675",
            "country_code": "US",
            "telephone_number": "586-439-6243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIENCZAK",
        "first_name": "AARON",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-18",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "MI",
            "license": "5201010574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "5201010574",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.