Benjamin S Roth

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

200 E Cedar St Ste 3
Le Roy, IL 61752-1903

Phone

(309) 962-3240

NPI assigned

Jan 25, 2021

Last updated

Jan 25, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Athletic and Therapeutic Institute of Bourbonnais, LLCGroup PAC ID 4183692577, 171 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

85.61 of 100Reported as group

Quality

90

Improvement activities

40

Cost

70.36

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Athletic and Therapeutic Institute of Bourbonnais, LLC

  dba ATI Physical Therapy

  • Physical Therapist
  • Bourbonnais, IL
  • NPI 1861503542
  Medicare reassignment Care Compare group NPD
• Ultra Physical Therapy LLC

  • Physical Therapist
  • Lexington, IL
  • NPI 1134743784
  Medicare reassignment NPD
• Athletic and Therapeutic Institute of Bourbonnais, LLC

  • Durable Medical Equipment & Medical Supplies
  • Columbia, IL
  • NPI 1124766696

  Physical Therapist

  NPD

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

{
    "created_epoch": "1611532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1124618046",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E CEDAR ST STE 3",
            "city": "LE ROY",
            "state": "IL",
            "postal_code": "617521903",
            "telephone_number": "309-962-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "BENJAMIN",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-25",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda A. Kube, M.D.
• Patricia Lynn Larkin, M.S., CCC-SLP/L
• Leroy Community School District 2
• Leroy Emergency Ambulance Service Inc
• Kendra McKean, OTR
• Srisai RX Mart LLC (Leroy Pharmacy)
• Srirat Temiyasathit, M.D.
• Jennifer Lynn Thomison, D.T.
• Unlimited Development, Inc. (UDI 4 Leroy Manor)
• Amy Zeleznik, MS CCC SLP/L

• Physical Therapist in Le Roy, IL
• Providers in Le Roy, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; 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.