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

Marivenkatesh Balamanickam

Individual provider Physical Therapist · NPI 1417101080

Marivenkatesh Balamanickam is a Physical Therapist in Private Practice in Northville, Michigan. Qualified in 2002, 24 years ago. Practices with Regain Therapy Services LLC, a 3-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
24
Licensed in
MI
In the registry since
2008
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Practice location Address checks out

235 E Main St Ste 104
Northville, MI 48167-2494
Phone: (248) 349-5050
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 5501013805 (MI)

Record details

NPI number1417101080
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedNovember 10, 2008
Last updated in NPPESNovember 10, 2008
Mailing address235 E Main St, Suite 104, Northville, MI 48167-2494

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Group practice Regain Therapy Services Llc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Northville