Individual provider Active NPI

Mary Joylene Rivera Along

  • Physical Therapist
  • Sunrise, FL
National Provider Identifier
1053734533
Registry record updated Feb 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.020337 Issued in IL
Practice address
1580 Sawgrass Corporate Pkwy Ste 100
Sunrise, FL 33323-2860
Phone
(954) 739-4247
NPI assigned
Feb 4, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2014

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 070.020337 IL Primary

Addresses

Primary practice location

1580 Sawgrass Corporate Pkwy Ste 100
Sunrise, FL 33323-2860

Mailing address

1580 Sawgrass Corporate Pkwy Ste 100
Sunrise, FL 33323-2860
Phone (954) 739-4247

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210618000079 IL Practitioner - Physical Therapist in Private Practice 8820498470 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.020337ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Therapeutics LTD Physical Therapist CurrentSince May 10, 2021 Accepting new patients
Comprehensive Therapeutics LTD Physical Therapist CurrentSince May 10, 2021 Accepting new patients
Medpro Healthcare Staffing Past Accepting new patients

Locations

1015 Oconor Ave
La Salle, IL 61301
Phone (224) 616-5446

2800 Desplaines Ave
Riverside, IL 60546
Phone (708) 443-4217

6300 Clarendon Hills Rd
Willowbrook, IL 60527
Phone (618) 534-7890

Organizations & group practices 3

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": "1391472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391472000000",
    "number": "1053734533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 SAWGRASS CORPORATE PKWY STE 100",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232860",
            "telephone_number": "954-739-4247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 SAWGRASS CORPORATE PKWY STE 100",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232860",
            "telephone_number": "954-739-4247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALONG",
        "first_name": "MARY JOYLENE",
        "middle_name": "RIVERA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-04",
        "last_updated": "2014-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.020337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.