UNIVERSITY PHYSICIAN GROUP (NPI# 1336492354) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336492354 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY PHYSICIAN GROUP |
| Other Organization Name | WAYNE STATE UNIVERSITY PHYSICIAN GROUP |
| Practice Address |
44000 W 12 Mile Rd Ste 205 Wsupg Pm&r Oakwood Novi MI 48377-2647 |
| Mailing Address |
1560 E. Maple Rd. Suite 400 - Credentialing Dept Troy MI 48083-1138 |
| Practice Telephone | 2484650100 |
| Practice Fax Number | 2484650107 |
| Mailing Telephone | 2485815973 |
| Mailing Fax Number | 2485815640 |
| Enumeration Date | 2012-10-16 |
| Last Update Date | 2016-10-26 |
| Authorized Official Name | MR. JEFFERY P KOHLITZ (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 2485815930 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225100000X | Physical Therapist | 4301083153 | MI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBSM GROUP# | 0H70318 | 01 |
| MI | MEDICARE GROUP # | 0P30630 | 01 |
| Other Name | Type Code |
|---|---|
| Wayne State University Physician Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457390254 | University Physician Group | Clinical Neuropsychologist | 4201 Saint Antoine St., Suite 8d, Detroit, MI 48201 | 2006-06-06 |
| 1447299797 | University Physician Group | Transplant Surgery | 4201 St. Antoine St., Detroit, MI 48201 | 2006-06-05 |
| 1114384757 | University Physician Group | Eyewear Supplier (Equipment, not the service) | 26400 W 12 Mile Rd, Suite 60, Southfield, MI 48034-1774 | 2016-01-27 |
| 1619380946 | University Physician Group | Pharmacist | 1560 E Maple Rd, Suite 400, Troy, MI 48083-1138 | 2014-06-04 |
| 1215379938 | University Physician Group | Eyewear Supplier (Equipment, not the service) | 1455 S Lapeer Rd, Suite 110, Lake Orion, MI 48360-1468 | 2013-07-23 |
| 1851630206 | University Physician Group | Occupational Therapist | 18100 Oakwood Blvd, Suite 300, Dearborn, MI 48124-4085 | 2013-02-05 |
| 1992044598 | University Physician Group | Prosthetic/Orthotic Supplier | 18100 Oakwood Blvd, Suite 300, Dearborn, MI 48124-4085 | 2013-02-04 |
| 1134492465 | University Physician Group | Eyewear Supplier (Equipment, not the service) | 4700 Schaefer Rd, Suite 260, Dearborn, MI 48126-3698 | 2012-02-16 |
| 1336417146 | University Physician Group | Speech-Language Pathologist | 4100 John R St, Karmanos Cancer Center-wertz Clinic, Detroit, MI 48201-2013 | 2011-12-07 |
| 1740590678 | University Physician Group | Eyewear Supplier (Equipment, not the service) | 4700 Schaefer Rd, Suite 165, Dearborn, MI 48126-3698 | 2010-10-13 |
| Street Address |
44000 W 12 MILE RD STE 205 WSUPG PM&R OAKWOOD |
| City | NOVI |
| State | MI |
| Zip Code | 48377-2647 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679075758 | Andrea Campbell | Nurse Practitioner | 44000 W 12 Mile Rd Ste 113, Novi, MI 48377 | 2018-03-05 |
| 1811421928 | Michigan Eye and Contact Lens Pllc | Optometrist | 42081 14 Mile Road, Novi, MI 48377 | 2017-04-14 |
| 1336695691 | Deanna Lynne Klein | Speech-Language Pathologist | 44140 Fox Run Road, Novi, MI 48377 | 2016-08-28 |
| 1871940973 | Jaime Durante | Nurse Practitioner | 44070 W. 12 Mile Rd, Suite 100, Novi, MI 48377 | 2016-05-18 |
| 1508225624 | Trilogy Healthcare of Oakland II, LLC | Skilled Nursing Facility | 41795 W 12 Mile Road, Novi, MI 48377 | 2016-02-17 |
| 1144688854 | Hussein Azzam | Allergy & Immunology | 46325 W 12 Mile Rd Ste 215, Novi, MI 48377 | 2016-02-09 |
| 1598120164 | Nova Counseling Services Inc. | Counselor | 41650 Clemens Circle, Novi, MI 48377 | 2015-12-23 |
| 1891174587 | Reem Mariam Mansour | Occupational Therapist | 44125 West 12 Mile Rd E-123, Novi, MI 48377 | 2015-05-27 |
| 1154747095 | Ali Hassan Ismail | Dentist | 41920 Wolfe Pass, Novi, MI 48377 | 2014-03-17 |
| 1558703876 | Twelve Oaks Orthodontics Pllc | Dentist | 44110 W 12 Mile Rd, Suite 100, Novi, MI 48377 | 2013-07-29 |
| Find all providers in zip 48377 | ||||
| Taxonomy Code | 225100000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT’s assess joint motion, muscle strength and endurance, function of heart and lungs, and performance of activities required in daily living, among other responsibilities. Treatment includes therapeutic exercises, cardiovascular endurance training, and training in activities of daily living. (2) A physical therapist is a person qualified by an accredited program in physical therapy, licensed by the state, and practicing within the scope of that license. Physical therapists treat disease, injury, or loss of a bodily part by physical means, such as the application of light, heat, cold, water, electricity, massage and exercise. They develop treatment plans based upon each patient’s strengths, weaknesses, range of motion and ability to function. (3) A health professional who specializes in physical therapy- the health care field concerned primarily with the treatment of disorders with physical agents and methods, such as massage, manipulation, therapeutic exercises, cold, heat (including short-wave, microwave, and ultrasonic diathermy), hydrotherapy, electric stimulation and light to assist in rehabilitating patients and in restoring normal function after an illness or injury. |
| Notes: Source: (1) APTA Guidelines for Physical Therapy Claims Review, American Physical Therapy Association. (3) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538767728 | Allen Physical Therapy Novi LLC | Physical Therapist | 26850 Providence Pkwy Ste 400, Novi, MI 48374-1263 | 2020-10-11 |
| 1578197844 | Vincent Tomasi | Physical Therapist | 26750 Providence Pkwy Ste 240, Novi, MI 48374-1211 | 2020-02-26 |
| 1518508753 | Natalie Ullrich | Physical Therapist | 39885 Grand River Ave Ste 300, Novi, MI 48375-2150 | 2019-09-30 |
| 1548737513 | Sarah Lynn Riggen | Physical Therapist | 23965 Novi Rd Ste 150, Novi, MI 48375-0203 | 2018-10-29 |
| 1578047809 | Allyson Leighanne White | Physical Therapist | 30479 Pennington Ln, Novi, MI 48377-1741 | 2018-09-22 |
| 1265913669 | Muhammad Tayyab | Physical Therapist | 23701 Harvest Dr, Novi, MI 48375-3147 | 2018-08-23 |
| 1689161507 | Dudeesh Purushothaman | Physical Therapist | 25032 Avon Ct, Novi, MI 48374-3165 | 2018-04-16 |
| 1740781368 | Annette Marie Bielski | Physical Therapist | 47601 Grand River Ave Ste A-201, Novi, MI 48374-1233 | 2018-02-28 |
| 1093216269 | Jody Tomasic | Physical Therapist | 40245 Grand River Ave, Novi, MI 48375-2119 | 2018-02-23 |
| 1366942864 | Gayle B Eves | Physical Therapist | 28455 Haggerty Rd Ste 200a, Novi, MI 48377-2982 | 2018-02-20 |
| Find all providers in NOVI | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.