Andrew Baltazar, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160.010311 Issued in IL

Practice address

404 McHenry Rd
Buffalo Grove, IL 60089-6740

Phone

(847) 885-0078

NPI assigned

Jan 2, 2025

Last updated

Jan 2, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Barrington Orthopedic Specialists LTD

  • Orthopaedic Surgery Physician
  • Schaumburg, IL
  • NPI 1336196476
  NPD (past)

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

{
    "created_epoch": "1735776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1144039397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 MCHENRY RD",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600896740",
            "telephone_number": "847-885-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 MCHENRY RD",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600896740",
            "telephone_number": "847-885-0078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALTAZAR",
        "first_name": "ANDREW",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-01-02",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.010311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Back to Function Physical Therapy LLC
• Elizabeth Badowski, PTA
• Mariana Baker
• Rhonda Levora Baldwin, M.A., CCC-SLP
• Sharon Elizabeth Balicki, ATC
• Nelli Ban
• Yelana Barsky, DPM
• Oksana Batejko, MD
• Sara Bayerle, PT, DPT
• Kristin Bean, PA-C

• Physical Therapy Assistant in Buffalo Grove, IL
• Providers in Buffalo Grove, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.