Individual provider Active NPI

Mary Jensen, DPT

  • Physical Therapist
  • Carmel, IN
National Provider Identifier
1043691611
Registry record updated Nov 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05015855A Issued in IN
Practice address
12505 Old Meridian St Ste 150
Carmel, IN 46032-8849
Phone
(317) 819-9500
NPI assigned
Jun 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 08348 LA
Physical Therapist 225100000X 05015855A IN Primary

Addresses

Primary practice location

12505 Old Meridian St Ste 150
Carmel, IN 46032-8849

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (803) 812-3656

Other practice location 1

2901 Ridgelake Dr
Ste 209
Metairie, LA 70002-4966
Phone (504) 309-0868

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251203004048 IN Practitioner - Physical Therapist in Private Practice 2466760046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

12505 Old Meridian St
Suite 150
Carmel, IN 46032-8849
Phone (317) 819-9500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05015855AINMDPhysical Therapist
08348LAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Nov 26, 2025 Accepting new patients
Athletico LTD Physical Therapist Current Accepting new patients
Athletico, LTD Physical Therapist CurrentSince Nov 26, 2025 Accepting new patients
Southern Flex Rehabilitation & Consulting, LLC Physical Therapist Past Accepting new patients

Locations

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

12505 Old Meridian St
Ste 150
Carmel, IN 46032
Phone (317) 819-9500

1505 US Highway 41
Ste A20
Schererville, IN 46375
Phone (219) 322-5560

Organizations & group practices 4

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": "1433808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764115200000",
    "number": "1043691611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "803-812-3656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12505 OLD MERIDIAN ST STE 150",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460328849",
            "telephone_number": "317-819-9500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2901 Ridgelake Dr",
            "address_2": "Ste 209",
            "address_purpose": "LOCATION",
            "city": "Metairie",
            "state": "LA",
            "postal_code": "700024966",
            "country_code": "US",
            "telephone_number": "504-309-0868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "MARY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-09",
        "last_updated": "2025-11-26",
        "certification_date": "2025-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "08348",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05015855A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2025; 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.