Individual provider Active NPI

Olymphia Roldan Tesoro, PT

  • Physical Therapist
  • Naperville, IL
National Provider Identifier
1083880322
Registry record updated May 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070006433 Issued in IL
Practice address
790 Royal Saint George Dr
Ste. 105
Naperville, IL 60563-8955
Phone
(630) 527-6370
Fax
(630) 527-6374
NPI assigned
May 6, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2008

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 070006433 IL Primary

Addresses

Primary practice location

790 Royal Saint George Dr
Ste. 105
Naperville, IL 60563-8955

Mailing address

790 Royal Saint George Dr
Ste. 105
Naperville, IL 60563-8955
Phone (630) 527-6370

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080512000351 IL Practitioner - Physical Therapist in Private Practice 6709965049 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Illinois Luna Care Physical Therapy LLCGroup PAC ID 5193153450, 129 clinicians

Practice addresses (Care Compare)

Naperville, IL 60563
Phone (866) 525-3175

Merit-based Incentive Payment System (MIPS)

Final score
90.43 of 100Reported as group
Quality
92.42
Improvement activities
40
Cost
72.83

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070006433ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pentafil Physical Therapy Services Current Accepting new patients
Illinois Luna Care Physical Therapy LLC Physical Therapist CurrentSince Nov 16, 2023 Accepting new patients

Locations

1755 Park St
Ste 200
Naperville, IL 60563
Phone (331) 244-0169

790 Royal Saint George Dr
Ste 105
Naperville, IL 60563
Phone (630) 527-6370

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1210032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210032000000",
    "number": "1083880322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 ROYAL SAINT GEORGE DR",
            "address_2": "STE. 105",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605638955",
            "telephone_number": "630-527-6370",
            "fax_number": "630-527-6374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 ROYAL SAINT GEORGE DR",
            "address_2": "STE. 105",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605638955",
            "telephone_number": "630-527-6370",
            "fax_number": "630-527-6374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TESORO",
        "first_name": "OLYMPHIA",
        "middle_name": "ROLDAN",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-06",
        "last_updated": "2008-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070006433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; 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.