Individual provider Active NPI

Noah Ebbens

  • Physical Therapist
  • Schererville, IN
National Provider Identifier
1043958077
Registry record updated Oct 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05014713A Issued in IN
Practice address
21 US Highway 41
Schererville, IN 46375-1201
Phone
(219) 923-4832
Fax
(219) 923-4838
NPI assigned
May 20, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2022

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
Physical Therapist 225100000X 05014713A IN Primary

Addresses

Primary practice location

21 US Highway 41
Schererville, IN 46375-1201

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-6250

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221018002302 IN Practitioner - Physical Therapist in Private Practice 3072989987 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians
Tricore Physical Therapy IncGroup PAC ID 2860646486, 5 clinicians

Practice addresses (Care Compare)

21 US Hwy 41
Schererville, IN 46375-1201
Phone (219) 923-4832

9859 Lincoln Plaza Way
Cedar Lake, IN 46303-7301
Phone (219) 567-1567

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist Current Accepting new patients
Athletico LTD Physical Therapist CurrentSince Aug 16, 2022 Accepting new patients
Athletico, LTD Physical Therapist CurrentSince Aug 16, 2022 Accepting new patients

Locations

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

21 US Highway 41
Schererville, IN 46375
Phone (219) 803-3880

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": "1653004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1043958077",
    "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": "630-575-6250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 US HIGHWAY 41",
            "city": "SCHERERVILLE",
            "state": "IN",
            "postal_code": "463751201",
            "telephone_number": "219-923-4832",
            "fax_number": "219-923-4838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBBENS",
        "first_name": "NOAH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-20",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05014713A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schererville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.