Interstate Rehab

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

INTERSTATE REHAB

Practice address

1000 John R Rd Ste 114
Troy, MI 48083-4317

Phone

(248) 850-8745

Fax

(248) 843-0044

NPI assigned

Oct 30, 2023

Organization subpart

No

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

Authorized official

Name

Gerardo B. Carbonell, DPTNPI 1942544341

Title

President

Phone

(586) 530-7114

Specialties & licenses 2

Addresses

Other names 1

• Essenza Physical Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Tax ID family

Essenza Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Interstate Rehab Inc

  • Physical Therapy Clinic/Center
  • Southfield, MI
  • NPI 1629359369
  NPD tax ID

Practitioners 1

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

• Gerardo B. Carbonell, PT, DPT

  • Physical Therapist
  • Troy, MI
  • NPI 1942544341
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1698624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698624000000",
    "number": "1992578231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 JOHN R RD STE 114",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480834317",
            "telephone_number": "248-850-8745",
            "fax_number": "248-843-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 JOHN R RD STE 114",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480834317",
            "telephone_number": "248-850-8745",
            "fax_number": "248-843-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERSTATE REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-30",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A",
        "authorized_official_last_name": "CARBONELL",
        "authorized_official_first_name": "GERARDO",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-530-7114",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Essenza Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Integrated Counseling Services
• Integrated Physical Therapy & Sports Rehabilitation PLLC
• Integritas Wellness Institute PLC
• Integrity Home Health Care, Inc.
• International Pharmacy Care, Inc.
• Intraspectives Counseling Services
• CHI Ying Shahin Ip, MA, LPC
• Iqbal Nasir MD FRCS PLLC
• Saarah Iqbal
• Marissa Isabell

• Physical Therapy Clinic/Center in Troy, MI
• Providers in Troy, MI by specialty
• Physical Therapy Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; 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.