NPIMap

Organization Active NPI

Peak Performance Solutions LLC

  • Physical Therapist
  • Ferndale, MI
National Provider Identifier
1992393417
Registry record updated Jan 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PEAK PERFORMANCE SOLUTIONS LLC
Practice address
668 E 9 Mile Rd
Ferndale, MI 48220-1962
Phone
(586) 871-4805
NPI assigned
Jan 10, 2021
Last updated
Jan 10, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2021

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

Authorized official

Name
Antwan Faraj, DPTNPI 1003361007
Title
Owner/Member
Phone
(586) 871-4805

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

668 E 9 Mile Rd
Ferndale, MI 48220-1962

Mailing address

344 E Harry Ave
Hazel Park, MI 48030-2055
Phone (586) 871-4805

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220124000912 MI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1254723356 Receives reassigned benefits from 9 practitioners
Practice locations: Ferndale, MI

National Provider Directory

National Provider Directory

Locations

530 Livernois St
Ferndale, MI 48220
Phone (248) 733-3784

668 E 9 Mile Rd
Ferndale, MI 48220
Phone (218) 234-1597

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1610236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610236800000",
    "number": "1992393417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "344 E HARRY AVE",
            "city": "HAZEL PARK",
            "state": "MI",
            "postal_code": "480302055",
            "telephone_number": "586-871-4805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "668 E 9 MILE RD",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482201962",
            "telephone_number": "586-871-4805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK PERFORMANCE SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-10",
        "last_updated": "2021-01-10",
        "certification_date": "2021-01-10",
        "status": "A",
        "authorized_official_last_name": "FARAJ",
        "authorized_official_first_name": "ANTWAN",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "586-871-4805",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ferndale, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2021; 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.