Michael Polydoras, OTR/L, CEAS

Primary specialty

Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X

Practice address

14349 Telegraph Rd
Redford, MI 48239-3359

Phone

(313) 592-0038

NPI assigned

Mar 7, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1362614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362614400000",
    "number": "1982945564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46647 MAIDSTONE RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481871468",
            "telephone_number": "734-262-1328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14349 TELEGRAPH RD",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482393359",
            "telephone_number": "313-592-0038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLYDORAS",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "OTR/L, CEAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-07",
        "last_updated": "2013-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XE1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Ergonomics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Plymouth Services Corp
• Eva Pointer
• Latris D Pointer
• Crystal Leigh Policelli
• Natalie Pollard
• Cheryl J Pope, MA
• Rosaundra Tanika Pope
• Posh Home Care, LLC
• Linda Potter-Gallant, MA, LLP
• Ashley Nichole Poulos, FNP-C

• Physical Rehabilitation Occupational Therapist in Redford, MI
• Providers in Redford, MI by specialty
• Physical Rehabilitation Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.