Individual provider Active NPI

Stefan Nedelea, P.T.

  • Physical Therapist
  • Bloomfield Hills, MI
National Provider Identifier
1992795181
Registry record updated Jun 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
SN008896 Issued in MI
Practice address
36880 Woodward Ave
Suite 104
Bloomfield Hills, MI 48304-0919
Phone
(248) 593-8677
Fax
(248) 593-8683
NPI assigned
Oct 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X SN008896 MI Primary

Addresses

Primary practice location

36880 Woodward Ave
Suite 104
Bloomfield Hills, MI 48304-0919

Mailing address

36880 Woodward Ave
Suite 104
Bloomfield Hills, MI 48304-0919
Phone (248) 593-8677

Other identifiers 1

IdentifierTypeStateIssuer
650F335540OtherMIBCBS

Other names 1

  • Mr. Stefan Nedelea Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SN008896MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hands on Physical Therapy Inc Physical Therapist Past Accepting new patients
Union Lake Physical Rehabilitation, LLC PastSince Jan 23, 2012 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277769600000",
    "number": "1992795181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36880 WOODWARD AVE",
            "address_2": "SUITE 104",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483040919",
            "telephone_number": "248-593-8677",
            "fax_number": "248-593-8683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36880 WOODWARD AVE",
            "address_2": "SUITE 104",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483040919",
            "telephone_number": "248-593-8677",
            "fax_number": "248-593-8683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEDELEA",
        "first_name": "STEFAN",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2010-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "SN008896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "650F335540",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEFAN",
            "last_name": "NEDELEA",
            "prefix": "MR.",
            "credential": "P.T.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Bloomfield Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; 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.