Individual provider Active NPI

Melissa Lynn Pugh, PT

  • Physical Therapist
  • Aurora, IL
National Provider Identifier
1063761104
Registry record updated Oct 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070019430 Issued in IL
Practice address
2340 S Eola Rd
Aurora, IL 60503
Phone
(630) 978-9200
NPI assigned
Sep 5, 2012
Last updated
Oct 1, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2019

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 070019430 IL Primary

Addresses

Primary practice location

2340 S Eola Rd
Aurora, IL 60503

Mailing address

811 Lenox Ave
Bolingbrook, IL 60490-4980
Phone (630) 818-5055

Other practice location 1

939 Burlington Ave
Downers Grove, IL 60515-4884
Phone (630) 963-8505

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://momentumphysicaltherapy.com/ Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130110000601 IL Practitioner - Physical Therapist in Private Practice 3870746316 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Third Eye Bliss PT 1 LLC Physical Therapist CurrentSince Mar 1, 2023 Accepting new patients
Third Eye Bliss Investments, Inc. Physical Therapist CurrentSince Mar 1, 2023 Accepting new patients
Brady, P.C. Physical Therapist CurrentSince Sep 3, 2019 Accepting new patients
Allied Therapy Partners, LLC. Physical Therapist CurrentSince Jun 15, 2023 Accepting new patients
Third Eye Bliss Investments, Inc. Physical Therapist CurrentSince Mar 1, 2023 Accepting new patients

Locations

2340 S Eola Rd
Ste 104
Aurora, IL 60503
Phone (630) 978-9200

1337 Lily Cache Ln
Bolingbrook, IL 60490
Phone (630) 226-5110

140 E Boughton Rd
Bolingbrook, IL 60440
Phone (312) 975-7045

12640 S Route 59
Unit 110
Plainfield, IL 60585
Phone (815) 676-3900

15412 S Route 59
Ste 118
Plainfield, IL 60544
Phone (630) 444-7353

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1063761104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 LENOX AVE",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604904980",
            "telephone_number": "630-818-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2340 S EOLA RD",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "60503",
            "telephone_number": "630-978-9200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "939 Burlington Ave",
            "address_purpose": "LOCATION",
            "city": "Downers Grove",
            "state": "IL",
            "postal_code": "605154884",
            "country_code": "US",
            "telephone_number": "630-963-8505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUGH",
        "first_name": "MELISSA",
        "middle_name": "LYNN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-05",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070019430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://momentumphysicaltherapy.com/",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "https://momentumphysicaltherapy.com/",
            "address_1": "2340 S Eola Rd",
            "city": "Aurora",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605036409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2019; 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.