Individual provider Active NPI

Tanya Kovacs, PT

  • Physical Therapist
  • New Lenox, IL
National Provider Identifier
1023322922
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070017967 Issued in IL
Practice address
602 Pine Grove CT
New Lenox, IL 60451-9658
Phone
(708) 705-6933
NPI assigned
Aug 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070017967 IL Primary

Addresses

Primary practice location

602 Pine Grove CT
New Lenox, IL 60451-9658

Mailing address

602 Pine Grove CT
New Lenox, IL 60451-9658
Phone (708) 705-6933

Other identifiers 1

IdentifierTypeStateIssuer
1023322922MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210930000184 IL Practitioner - Physical Therapist in Private Practice 5193122307 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
May accept Medicare assignment
Group practices
Theracore, Inc.Group PAC ID 9234200049, 7 clinicians

Practice addresses (Care Compare)

16622 W 159TH St
Suite 503
Lockport, IL 60441-8015
Phone (815) 838-5070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070017967ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Theracore, Inc. Physical Therapist CurrentSince Sep 15, 2021 Accepting new patients

Locations

16622 W 159th St
Ste 503
Lockport, IL 60441
Phone (815) 838-5070

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1280793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1023322922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 PINE GROVE CT",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604519658",
            "telephone_number": "708-705-6933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 PINE GROVE CT",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604519658",
            "telephone_number": "708-705-6933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVACS",
        "first_name": "TANYA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-03",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070017967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023322922",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Lenox, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.