Individual provider Active NPI

Praneeth Purimetla, PT, DPT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1083038897
Registry record updated Feb 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070020269 Issued in IL
Practice address
2250 W Belmont Ave
Unit 1W
Chicago, IL 60618-6561
Phone
(773) 888-3233
Fax
(773) 883-2336
NPI assigned
Feb 13, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 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 070020269 IL Primary

Addresses

Primary practice location

2250 W Belmont Ave
Unit 1W
Chicago, IL 60618-6561

Mailing address

2250 W Belmont Ave
Unit 1W
Chicago, IL 60618-6561
Phone (773) 883-2337

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150910002401 IL Practitioner - Physical Therapist in Private Practice 5294042099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2250 W Belmont Ave
Unit 1W
Chicago, IL 60618-6561
Phone (773) 883-2337

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070020269ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
El Rey Corporation Physical Therapist CurrentSince Nov 24, 2016 Accepting new patients
Journey Physical Therapy Physical Therapist PastSince Sep 9, 2015 Accepting new patients

Organizations & group practices 2

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": "1392249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392768000000",
    "number": "1083038897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 W BELMONT AVE",
            "address_2": "UNIT 1W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606186561",
            "telephone_number": "773-883-2337",
            "fax_number": "773-883-2336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 W BELMONT AVE",
            "address_2": "UNIT 1W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606186561",
            "telephone_number": "773-888-3233",
            "fax_number": "773-883-2336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURIMETLA",
        "first_name": "PRANEETH",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-13",
        "last_updated": "2014-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070020269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2014; 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.