FOUNDATION MANUAL PHYSICAL THERAPY AND PERFORMANCE PLLC – Physical Therapy Clinic/Center, NPI 1790453322

FOUNDATION MANUAL PHYSICAL THERAPY AND PERFORMANCE PLLC is a healthcare provider. based in Grosse pointe woods, Michigan. specializing in Physical Therapy Clinic/Center. The NPI Number for FOUNDATION MANUAL PHYSICAL THERAPY AND PERFORMANCE PLLC is 1790453322

Main info

Organization
Name
FOUNDATION MANUAL PHYSICAL THERAPY AND PERFORMANCE PLLC
NPI
1790453322
Phone
(586) 615-8585
Address
1756 HUNTINGTON BLVD
Authorized Official
MR. DOUGLAS EDWARD JOHNSON PHYSICAL THERAPIST DPT
Enumeration Date
30 August 2021
Last Update Date
30 August 2021

Contacts

Main Contact
EMR
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness85
Years active:4State licenses:0Other namesUpdated within 12 months

Provider Addresses for FOUNDATION MANUAL PHYSICAL THERAPY AND PERFORMANCE PLLC

  • 1756 HUNTINGTON BLVD

    GROSSE POINTE WOODS, MI 482361916

    Phone: (586) 615-8585

    Type: Mailing

  • 120 CATALPA DR

    ROYAL OAK, MI 480671242

    Phone: (586) 615-8585

    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: 2021-11-01

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20211101002108OPhysical/Occupational Therapy Group In Private PracticeMITBD

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.

Verify on CMS Revalidation Lookup Tool

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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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48236)

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Reviews

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Frequently asked questions

What unique ID ties claims to FOUNDATION MANUAL PHYSICAL THERAPY AND PERFORMANCE PLLC?
NPI 1790453322 is assigned to FOUNDATION MANUAL PHYSICAL THERAPY AND PERFORMANCE PLLC under the national enumeration system.
Is FOUNDATION MANUAL PHYSICAL THERAPY AND PERFORMANCE PLLC active in the national directory?
FOUNDATION MANUAL PHYSICAL THERAPY AND PERFORMANCE PLLC's public NPI profile is in an active state.
What field does FOUNDATION MANUAL PHYSICAL THERAPY AND PERFORMANCE PLLC work in?
You can think of FOUNDATION MANUAL PHYSICAL THERAPY AND PERFORMANCE PLLC as practicing within Physical Therapy Clinic/Center. Clinical services aligned with this taxonomy classification.
Where is FOUNDATION MANUAL PHYSICAL THERAPY AND PERFORMANCE PLLC's primary listing?
We display Grosse Pointe Woods, Michigan because that is what the record indicates for FOUNDATION MANUAL PHYSICAL THERAPY AND PERFORMANCE PLLC.
What if Grosse Pointe Woods, Michigan seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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