Individual provider Active NPI

Danielle Mallillin Pera, DPT

  • Physical Therapist
  • Plano, TX
National Provider Identifier
1093348807
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1300 N Central Expy
Plano, TX 75074-1009
Phone
(972) 578-2212
NPI assigned
Feb 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 1329172 TX
Physical Therapist 225100000X Primary

Addresses

Primary practice location

1300 N Central Expy
Plano, TX 75074-1009

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (866) 370-8206

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221028000391 TX Practitioner - Physical Therapist in Private Practice 5698142065 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ideal Physical Therapy of Texas LLCGroup PAC ID 0547583809, 359 clinicians

Practice addresses (Care Compare)

7410 McCart Ave
Suite 108
Fort Worth, TX 76133-7427
Phone (682) 350-4318

Merit-based Incentive Payment System (MIPS)

Final score
85.56 of 100Reported as group
Quality
89.48
Improvement activities
40
Cost
71.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1329172TXMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Physical Therapy of Texas LLC CurrentSince Oct 10, 2022 Accepting new patients
Ideal Physical Therapy of Texas LLC Physical Therapist CurrentSince Oct 10, 2022 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

1267 W Exchange Pkwy
Ste 150
Allen, TX 75013
Phone (469) 342-0641

4100 Fairway Dr
Ste 400
Carrollton, TX 75010
Phone (972) 394-3325

7410 McCart Ave
Ste 108
Fort Worth, TX 76133
Phone (682) 350-4318

8845 Gary Burns Dr
Ste 100
Frisco, TX 75034
Phone (469) 403-2090

3241 S Custer Rd
Ste 101
McKinney, TX 75070

3520 W University Dr
Ste 201
McKinney, TX 75071
Phone (469) 307-5674

1180 E Prosper Trl
Ste 50
Prosper, TX 75078
Phone (469) 481-3031

5400 Brodie Ln
Ste 295
Sunset Valley, TX 78745
Phone (512) 676-3949

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": "1582156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1093348807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "866-370-8206",
            "fax_number": "517-435-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N CENTRAL EXPY",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750741009",
            "telephone_number": "972-578-2212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERA",
        "first_name": "DANIELLE",
        "middle_name": "MALLILLIN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-20",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "TX",
            "license": "1329172",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; 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.