NPIMap

Organization Active NPI

Trishard P.C.

  • Rehabilitation Clinic/Center
  • Warren, MI
National Provider Identifier
1992793442
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
TRISHARD P.C.
Practice address
2117 E 11 Mile Rd
Warren, MI 48092-3553
Phone
(586) 573-4684
Fax
(586) 573-2575
NPI assigned
Oct 10, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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

Authorized official

Name
Patricia Ann Pantelli, MA,CCC-SLP
Title
Administrator
Phone
(248) 568-3563

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X MI
Rehabilitation Clinic/Center 261QR0400X MI Primary

Addresses

Primary practice location

2117 E 11 Mile Rd
Warren, MI 48092-3553

Mailing address

2117 E 11 Mile Rd
Warren, MI 48092-3553
Phone (586) 573-4684

Other identifiers 2

IdentifierTypeStateIssuer
30628OtherMIBLUE CROSS BLUE SHIELD
30628OtherMIBLUE CARE NETWORK

Other names 1

  • Michigan Therapy Institute Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050128000198 MI Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 7618927534 Practice locations: Macomb, MI; Warren, MI

National Provider Directory

National Provider Directory

Locations

34736 S Gratiot Ave
Clinton Township, MI 48035
Phone (586) 790-9660

39425 Garfield Rd
Ste 25
Clinton Twp, MI 48038
Phone (586) 286-4480

22573 Hall Rd
Macomb, MI 48042
Phone (586) 231-0043

6585 Rochester Rd
Ste 102
Troy, MI 48085
Phone (833) 823-3300

2117 E 11 Mile Rd
Warren, MI 48092
Phone (586) 573-4684

Practitioners & affiliated clinicians

Practitioners 77

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

View all 77

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678752000000",
    "number": "1992793442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2117 E 11 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480923553",
            "telephone_number": "586-573-4684",
            "fax_number": "586-573-2575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2117 E 11 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480923553",
            "telephone_number": "586-573-4684",
            "fax_number": "586-573-2575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRISHARD P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-10",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A",
        "authorized_official_last_name": "PANTELLI",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "248-568-3563",
        "authorized_official_credential": "MA,CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "30628",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "30628",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michigan Therapy Institute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Michigan Therapy Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.