MR. SIDHARTH ANNEBOINA (PT) – Physical Therapist, NPI 1659683407
Physical Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,459 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MI
Provider Addresses for MR. SIDHARTH ANNEBOINA (PT)
790 REMINGTON BLVD
BOLINGBROOK, IL 604404909
Phone: (866) 370-8206
Fax: (517) 435-3678
Type: Mailing
20363 NORTHVILLE PLACE DR
APT#2418
NORTHVILLE TOWNSHIP, MI 481672991
Phone: (248) 225-4164
Type: Mailing
12370 WOODWARD AVE
HIGHLAND PARK, MI 482033322
Phone: (313) 252-4000
Fax: (313) 252-4015
Type: Location
26750 Providence Pkwy Ste 240
Novi, MI 483741211
Phone: (669) 742-6738
Fax: (866) 939-2673
Type: Location
18444 N 25TH AVE STE 310
PHOENIX, AZ 850231266
Phone: (866) 974-2673
Fax: (866) 939-2673
Type: Mailing
26750 PROVIDENCE PKWY STE 240
NOVI, MI 483741211
Phone: (669) 742-6738
Fax: (866) 939-2673
Type: Location
202 E VAN RIPER RD STE 200
FOWLERVILLE, MI 488367947
Phone: (517) 223-2100
Fax: (517) 223-2101
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-07-19
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190719002546 | I | Physical Therapist In Private Practice | MI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 97530 | Therapy procedure using functional activities | 512 | 55 | $0 |
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 320 | 56 | $0 |
| 97140 | Therapy procedure using manual technique, each 15 minutes | 147 | 45 | $0 |
| 97112 | Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 43 | 17 | $0 |
| 97163 | Evaluation for physical therapy, typically 45 minutes | 27 | 24 | $0 |
Insurance plans in this area (ZIP 60440)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | MI |
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