Individual provider Active NPI

Brittany Ardagna, PT

  • Physical Therapist
  • Crystal Lake, IL
National Provider Identifier
1093293540
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070027925 Issued in IL
Practice address
750 E Terra Cotta Ave Ste D
Crystal Lake, IL 60014-3621
Phone
(815) 404-2568
Fax
(815) 287-9556
NPI assigned
Aug 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4393 NH
Physical Therapist 225100000X 070027925 IL Primary

Addresses

Primary practice location

750 E Terra Cotta Ave Ste D
Crystal Lake, IL 60014-3621

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-6200

Other identifiers 1

IdentifierTypeStateIssuer
4393OtherNHSTATE OF NH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180817000162 NH Practitioner - Physical Therapist in Private Practice 7911256474 Reassigns benefits to 1 organization
I20240124003501 IL Practitioner - Physical Therapist in Private Practice 7911256474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

1860 E Belvidere Rd
Grayslake, IL 60030-2289
Phone (847) 548-0360

722 N McLean Blvd
South Elgin, IL 60177-1429
Phone (847) 695-5088

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

State licenses

LicenseStateTypeSpecialty
4393NHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Jan 8, 2024 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Jan 8, 2024 Accepting new patients
Merrimack Valley Physical Therapy Physical Therapist CurrentSince Aug 1, 2018 Accepting new patients

Locations

750 E Terra Cotta Ave
Ste D
Crystal Lake, IL 60014
Phone (815) 404-2568

280 N Randall Rd
Lake in the Hills, IL 60156
Phone (847) 854-8219

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

722 N McLean Blvd
South Elgin, IL 60177
Phone (847) 695-5088

40 S River Rd
Unit 58
Bedford, NH 03110
Phone (603) 626-4205

5 Clinton St
Concord, NH 03301
Phone (603) 224-3511

12 Parmenter Rd
Unit C7
Londonderry, NH 03053
Phone (603) 434-6592

835 Hanover St
Ste 102
Manchester, NH 03104
Phone (603) 625-1864

76 Northeastern Blvd
Ste 24B
Nashua, NH 03062
Phone (603) 943-5029

Interoperability endpoints

  • Direct secure messaging: brittany.ardagna.p9@direct.athleticoltd.nextgenshare.com

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": "1533513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1093293540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E TERRA COTTA AVE STE D",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143621",
            "telephone_number": "815-404-2568",
            "fax_number": "815-287-9556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARDAGNA",
        "first_name": "BRITTANY",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-06",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "4393",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070027925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF NH",
            "identifier": "4393",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; 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.