Individual provider Active NPI

Thomas Spevak, PT

  • Physical Therapist
  • Bloomington, IN
National Provider Identifier
1073837761
Registry record updated Dec 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05002211A Issued in IN
Practice address
1375 N Wellness Way
Bloomington, IN 47404-9786
Phone
(812) 676-4111
Fax
(812) 676-4110
NPI assigned
Mar 24, 2010
Last updated
Dec 4, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2013

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 05002211A IN Primary

Addresses

Primary practice location

1375 N Wellness Way
Bloomington, IN 47404-9786

Mailing address

PO Box 1329
Bloomington, IN 47402-1329
Phone (812) 353-3087

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140310000496 IN Practitioner - Physical Therapist in Private Practice 8820228000 Reassigns benefits to 3 organizations
I20170929002501 NY Practitioner - Physical Therapist in Private Practice 8820228000 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

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 CurrentSince Jan 15, 2022 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Physical Therapist CurrentSince May 14, 2022 Accepting new patients
Gold Standard Physical Therapy, PLLC Physical Therapist CurrentSince May 1, 2018 Accepting new patients
Advanced Physical Therapy, LLC Physical Therapist CurrentSince Oct 21, 2018 Accepting new patients
Affinity Rehabilitation LLP CurrentSince Aug 21, 2017 Accepting new patients
Advanced Physical Therapy, LLC Physical Therapist CurrentSince Oct 21, 2018 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Jan 15, 2022 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Physical Therapist CurrentSince May 14, 2022 Accepting new patients

Locations

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

1155 S College Mall Rd
Ste A
Bloomington, IN 47401
Phone (812) 558-3356

1312 W Arch Haven Ave
Ste E
Bloomington, IN 47403
Phone (812) 336-8406

5949 W Raymond St
Indianapolis, IN 46241
Phone (317) 247-1579

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

500 N Columbus Ave
Mount Vernon, NY 10552
Phone (914) 266-3796

271 Madison Ave
Rm 1400
New York, NY 10016
Phone (212) 481-4022

536 Old Howell Rd
Greenville, SC 29615
Phone (877) 508-3237

Organizations & group practices 8

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": "1269388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386115200000",
    "number": "1073837761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1329",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474021329",
            "telephone_number": "812-353-3087",
            "fax_number": "812-353-5859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 N WELLNESS WAY",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474049786",
            "telephone_number": "812-676-4111",
            "fax_number": "812-676-4110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEVAK",
        "first_name": "THOMAS",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-24",
        "last_updated": "2013-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05002211A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2013; 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.