Individual provider Active NPI

Andrea M Martell, MPT

  • Physical Therapist
  • Glendale, AZ
National Provider Identifier
1043335979
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070012436 Issued in IL
Practice address
17600 N 79TH Ave
Apt 102
Glendale, AZ 85308-8682
Phone
(304) 942-5456
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 2126 WV
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 070012436 IL Primary

Addresses

Primary practice location

17600 N 79TH Ave
Apt 102
Glendale, AZ 85308-8682

Mailing address

17600 N 79TH Ave
Apt 102
Glendale, AZ 85308-8682
Phone (304) 942-5456

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141113001105 IL Practitioner - Physical Therapist in Private Practice 9436375227 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Illinois Luna Care Physical Therapy LLCGroup PAC ID 5193153450, 129 clinicians
Three Point Healthcare LLCGroup PAC ID 9133484694, 26 clinicians

Practice addresses (Care Compare)

Naperville, IL 60563
Phone (866) 525-3175

4817 -4819 W 95TH St
Oak Lawn, IL 60453-2051
Phone (708) 938-3378

Merit-based Incentive Payment System (MIPS)

Final score
85.3 of 100Reported as group
Quality
88.48
Improvement activities
40
Cost
72.11

Merit-based Incentive Payment System (MIPS)

Final score
86.49 of 100Reported as group
Quality
90
Improvement activities
40
Cost
73.3

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2126WVMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Three Point Healthcare LLC Single Specialty CurrentSince Jun 15, 2022 Accepting new patients
Illinois Luna Care Physical Therapy LLC Single Specialty CurrentSince Jan 30, 2025 Accepting new patients

Locations

1415 W 47th St
Lagrange Hlds, IL 60525
Phone (708) 352-5652

19805 S La Grange Rd
Mokena, IL 60448
Phone (708) 938-3378

1755 Park St
Ste 200
Naperville, IL 60563
Phone (331) 244-0169

Organizations & group practices 2

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": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1043335979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17600 N 79TH AVE",
            "address_2": "APT 102",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088682",
            "telephone_number": "304-942-5456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17600 N 79TH AVE",
            "address_2": "APT 102",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088682",
            "telephone_number": "304-942-5456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTELL",
        "first_name": "ANDREA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "MPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WV",
            "license": "2126",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070012436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; 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.