Individual provider Active NPI

Michael Grzetic, DPT

  • Physical Therapist
  • Geneva, IL
National Provider Identifier
1144711482
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070027107 Issued in IL
Practice address
2000 W State St Ste F
Geneva, IL 60134-3696
Phone
(877) 632-6637
Fax
(708) 409-5179
NPI assigned
May 22, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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 12894 TN
Physical Therapist 225100000X 070027107 IL Primary

Addresses

Primary practice location

2000 W State St Ste F
Geneva, IL 60134-3696

Mailing address

2000 W State St Ste F
Geneva, IL 60134-3696
Phone (877) 632-6637

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221207002039 IL Practitioner - Physical Therapist in Private Practice 7911252002 Reassigns benefits to 2 organizations

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
Orthomidwest, PLLCGroup PAC ID 0749183713, 531 clinicians

Practice addresses (Care Compare)

2000 W State St
Suite F
Geneva, IL 60134-3696
Phone (877) 632-6637

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12894TNMDDentist
070027107ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Orthopaedics at Rush, LLC CurrentSince Dec 5, 2022 Accepting new patients
Orthomidwest, PLLC Physical Therapist CurrentSince Dec 5, 2022 Accepting new patients
Midwest Orthopaedics at Rush LLC CurrentSince Dec 5, 2022 Accepting new patients
Orthomidwest, PLLC CurrentSince Dec 5, 2022 Accepting new patients

Locations

770 Beloit Rd
Belvidere, IL 61008
Phone (815) 847-7060

1611 W Harrison St
Ste 400
Chicago, IL 60612
Phone (312) 243-4244

2000 W State St
Ste F
Geneva, IL 60134
Phone (708) 492-5720

1 Westbrook Corporate Ctr
Ste 240
Westchester, IL 60154

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

Interoperability endpoints

  • Direct secure messaging: michael.grzetic.1@12576.direct.athenahealth.com

Organizations & group practices 4

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": "1526947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1144711482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 W STATE ST STE F",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601343696",
            "telephone_number": "877-632-6637",
            "fax_number": "708-409-5179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 W STATE ST STE F",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601343696",
            "telephone_number": "877-632-6637",
            "fax_number": "708-409-5179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRZETIC",
        "first_name": "MICHAEL",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-22",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "12894",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070027107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; 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.