Form Physical Therapy, LLC
NPI 1750844619 · Physical Therapy Clinic/Center · Saint Clair Shores, MI
Enrolled with Medicare as Part B Supplier - Physical/Occupational Therapy Group in Private Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Form Physical Therapy, LLC is a Physical Therapy Clinic/Center organization in Saint Clair Shores, MI (NPI 1750844619).
Provider details
- NPI number
- 1750844619
- Entity type
- Organization
- Primary specialty
- Physical Therapy Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Kelly Delind, Physical Therapist(248) 860-1329
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2019-04-08
- Last updated
- 2019-04-08
Frequently asked questions
- What is Form Physical Therapy, LLC's NPI number?
- Form Physical Therapy, LLC's National Provider Identifier (NPI) is 1750844619, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Form Physical Therapy, LLC?
- Form Physical Therapy, LLC is classified in the NPPES registry as Physical Therapy Clinic/Center (Ambulatory Health Care Facilities).
- Where is Form Physical Therapy, LLC located?
- Form Physical Therapy, LLC's practice location on file with NPPES is 22340 Harper Ave, Saint Clair Shores, MI 48080-1818.
- What is Form Physical Therapy, LLC's phone number?
- The practice phone number listed in the NPPES registry for Form Physical Therapy, LLC is (586) 330-0499.
- Does Form Physical Therapy, LLC accept Medicare?
- Form Physical Therapy, LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Form Physical Therapy, LLC?
- The authorized official listed on Form Physical Therapy, LLC's NPPES record is Kelly Delind, Physical Therapist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Form Physical Therapy, LLC's NPI active?
- Yes — Form Physical Therapy, LLC's NPI (1750844619) is active in the NPPES registry as of the last update on 2019-04-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.