Brookside Pediatric Therapy Llc is a medicare enrolled "Clinic/center - Mental Health (including Community Mental Health Center)" provider in Novi, Michigan. Their current practice location is
39650 Orchard Hill Pl, Novi, Michigan. You can reach out to their office (for appointments etc.) via phone at
(248) 747-4263.
Brookside Pediatric Therapy Llc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Brookside Pediatric Therapy Llc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1467225946.
Healthcare Provider's Profile
| Full Name | Brookside Pediatric Therapy Llc |
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| Type | Facility |
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| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
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| Location | 39650 Orchard Hill Pl, Novi, Michigan |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1467225946
- Provider Enumeration Date: 11/06/2023
- Last Update Date: 10/07/2024
Medicare PECOS Information:
- PECOS PAC ID: 0648623504
- Enrollment ID: O20240731000488
Medical Identifiers
Medical identifiers for Brookside Pediatric Therapy Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1467225946 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225XP0019X | Occupational Therapist - Physical Rehabilitation | (* (Not Available)) | Secondary |
| 225XP0200X | Occupational Therapist - Pediatrics | (* (Not Available)) | Secondary |
| 2355S0801X | Specialist/technologist - Speech-language Assistant | (* (Not Available)) | Secondary |
| 235Z00000X | Speech-language Pathologist | (* (Not Available)) | Secondary |
| 251B00000X | Case Management | (* (Not Available)) | Secondary |
| 252Y00000X | Early Intervention Provider Agency | (* (Not Available)) | Secondary |
| 103K00000X | Behavior Analyst | (* (Not Available)) | Secondary |
| 106E00000X | Assistant Behavior Analyst | (* (Not Available)) | Secondary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Secondary |
| 171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Secondary |
| 225100000X | Physical Therapist | (* (Not Available)) | Secondary |
| 225200000X | Physical Therapy Assistant | (* (Not Available)) | Secondary |
| 225XM0800X | Occupational Therapist - Mental Health | (* (Not Available)) | Secondary |
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Brookside Pediatric Therapy Llc acts as a billing entity for following providers:
| Provider Name | Lama Mansour |
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| Provider Type | Practitioner - Qualified Speech Language Pathologist |
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| Provider Identifiers | NPI Number: 1447621438
PECOS PAC ID: 0446539803
Enrollment ID: I20161227001394 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Brookside Pediatric Therapy Llc is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Brookside Pediatric Therapy Llc
39650 Orchard Hill Pl,
Novi, MI 48375-5392
Ph: (248) 266-1188 | Brookside Pediatric Therapy Llc
39650 Orchard Hill Pl,
Novi, MI 48375-5392
Ph: (248) 747-4263 |
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