Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Gaurav Mitra

Individual provider Physical Therapist · NPI 1104078443

Gaurav Mitra is a Physical Therapist in Private Practice in Imlay City, Michigan. Qualified in 2007, 19 years ago. Practices with Michigan Luna Care Physical Therapy LLC, a 52-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
19
Licensed in
MI
In the registry since
2008

Practice location Address checks out

1769 S Cedar St
Imlay City, MI 48444-1300
Phone: (810) 724-0421
Fax: (810) 721-0423
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 5501013172 (MI)

Record details

NPI number1104078443
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 17, 2008
Last updated in NPPESMarch 24, 2009
Mailing address1769 S Cedar St, Imlay City, MI 48444-1300

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Michigan Luna Care Physical Therapy Llc — 52 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Imlay City