UNIVERSITY PHYSICIAN GROUP (NPI# 1851630206) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851630206 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY PHYSICIAN GROUP |
| Other Organization Name | WAYNE STATE UNIVERSITY PHYSICIAN GROUP |
| Practice Address |
18100 Oakwood Blvd Suite 300 Dearborn MI 48124-4085 |
| Mailing Address |
1560 E. Maple Rd. Suite 400-credentialing Troy MI 48083-1138 |
| Practice Telephone | 3134297977 |
| Practice Fax Number | 3134297981 |
| Mailing Telephone | 2485815973 |
| Mailing Fax Number | 2485815640 |
| Enumeration Date | 2013-02-05 |
| 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 | 225X00000X | Occupational Therapist | 4301028224 | MI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBSM GROUP # | 0H28367 | 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 |
|---|---|---|---|---|
| 1336492354 | University Physician Group | Physical Therapist | 44000 W 12 Mile Rd Ste 205, Wsupg Pm&r Oakwood, Novi, MI 48377-2647 | 2012-10-16 |
| 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 |
| 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 |
18100 OAKWOOD BLVD SUITE 300 |
| City | DEARBORN |
| State | MI |
| Zip Code | 48124-4085 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578535142 | Lawrence G Morawa | Orthopaedic Surgery | 18100 Oakwood Blvd, 300, Dearborn, MI 48124-4085 | 2006-02-07 |
| 1992110522 | Michelle T Leonard | Psychologist | 18100 Oakwood Blvd, C/o Michelle Leonard, Dearborn, MI 48124-4085 | 2014-06-23 |
| 1801215959 | Lassen Dialysis LLC | Clinic/Center | 18100 Oakwood Blvd, Ste 206, Dearborn, MI 48124-4085 | 2014-04-15 |
| 1992044598 | University Physician Group | Prosthetic/Orthotic Supplier | 18100 Oakwood Blvd, Suite 300, Dearborn, MI 48124-4085 | 2013-02-04 |
| 1073878682 | Tiona Kimisha Stephens | Internal Medicine | 18100 Oakwood Blvd, Site 01 Medical Education, Dearborn, MI 48124-4085 | 2012-07-10 |
| 1598052441 | Geoffrey Alan Potts | Dermatology | 18100 Oakwood Blvd, Suite 300, Dearborn, MI 48124-4085 | 2011-06-29 |
| 1346565355 | Mariana Dimovski Atanasovski | Dermatology | 18100 Oakwood Blvd, Suite 300, Dearborn, MI 48124-4089 | 2010-04-01 |
| 1821310806 | Oakwood Healthcare Inc | Clinic/Center | 18100 Oakwood Blvd, Suite 206, Dearborn, MI 48124-4085 | 2010-02-18 |
| 1114257540 | Dynamic Urocare PC | Urology | 18100 Oakwood Blvd, Ste 315, Dearborn, MI 48124-4085 | 2010-01-07 |
| 1023248085 | Violet Asfour | Internal Medicine | 18100 Oakwood Blvd, Dearborn, MI 48124-4085 | 2009-07-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396389524 | Pharma A, LLC | Pharmacy | 23916 Michigan Ave, Dearborn, MI 48124 | 2019-10-31 |
| 1225683725 | Aysha Said | Behavior Technician | 1369 Porter St, Dearborn, MI 48124 | 2019-08-02 |
| 1881257772 | Leen Nusairat | Internal Medicine | Beaumont Health-dearborn Campus, 18101 Oakwood Blvd, Dearborn, MI 48124 | 2019-04-17 |
| 1417413360 | Gary C. Veraghen, Dds, PC | Dentist | 22100 W. Outer Drive, Dearborn, MI 48124 | 2019-02-15 |
| 1982168787 | Fnu Asma Manzar | Physical Therapist | Global Physical Therapy Services, Inc, 22819 Michigan Avenue, Dearborn, MI 48124 | 2019-01-25 |
| 1639640162 | Jernia Lashawn Usher | Behavior Technician | 1360 Porter St Lower Level, Dearborn, MI 48124 | 2018-12-10 |
| 1710456470 | Samar Fouad Hannawi | Psychologist | 3815 Pelham Street, Suite #13, Dearborn, MI 48124 | 2018-11-24 |
| 1881178747 | Sarah Chehab | Psychologist | 835 Mason St Suite 220b, Dearborn, MI 48124 | 2018-09-17 |
| 1568948289 | Ibrahim M Basma | Pharmacist | 22521 Michigan Avenue, Dearborn, MI 48124 | 2018-07-16 |
| 1669961942 | Jacqueline E Domzalski | Technician, Other | 3231 S. Gulley, Suite E, Dearborn, MI 48124 | 2018-05-02 |
| Find all providers in zip 48124 | ||||
| Taxonomy Code | 225X00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapist |
| An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life. |
| Notes: Source: The Guide to Occupational Therapy Practice, 2nd edition. Bethesda: American Occupational Therapy Association, 2007. [7/1/2008: definition changed, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740889146 | Samaah Abboud Khanafer | Occupational Therapist | 1036 N Denwood St, Dearborn, MI 48128-1569 | 2020-10-19 |
| 1235611823 | Trudy Bazzy | Occupational Therapist | 5111 Fairlane Woods Dr, Dearborn, MI 48126-2612 | 2018-08-30 |
| 1144721101 | Renee P Coughlin | Occupational Therapist | 19401 Hubbard Dr Ste 201, Dearborn, MI 48126-2641 | 2018-02-26 |
| 1508371493 | Nucare Therapy, LLC | Occupational Therapist | 4700 Greenfield Rd Ste 2b, Dearborn, MI 48126-4124 | 2017-12-13 |
| 1497282495 | Alyssa Martino | Occupational Therapist | 5141 Oakman Blvd Ste D, Dearborn, MI 48126-3763 | 2017-05-22 |
| 1003354341 | Samantha Baker | Occupational Therapist | 22731 Newmand Street, Suite 100b, Dearborn, MI 48124 | 2017-02-07 |
| 1417311184 | Advanced Balance Clinic LLC | Occupational Therapist | 1063 Walnut St, Dearborn, MI 48124-4019 | 2016-04-08 |
| 1083001697 | Melanie Ward | Occupational Therapist | 20469 Outer Dr, Dearborn, MI 48124-2641 | 2015-04-21 |
| 1285932012 | Nicholas Paul Gerasimoff | Occupational Therapist | 22731 Newman St Ste 100b, Dearborn, MI 48124-2023 | 2011-03-02 |
| 1972725604 | Margaret Amm Brennan | Occupational Therapist | 18700 Audette St, Dearborn, MI 48124-4222 | 2007-05-03 |
| Find all providers in DEARBORN | ||||
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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.