Individual provider Active NPI

Regina M Roderick, PT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1164642872
Registry record updated Feb 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070012854 Issued in IL
Practice address
7447 W Talcott Ave
Ste 500
Chicago, IL 60631-3716
Phone
(773) 631-7898
Fax
(773) 361-3005
NPI assigned
Apr 26, 2007
Last updated
Feb 12, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070012854 IL Primary

Addresses

Primary practice location

7447 W Talcott Ave
Ste 500
Chicago, IL 60631-3716

Mailing address

7447 W Talcott Ave
Ste 500
Chicago, IL 60631-3716
Phone (773) 631-7898

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051221000229 IL Practitioner - Physical Therapist in Private Practice 6800818691 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1550 N Northwest Hwy
Suite 120
Park Ridge, IL 60068-1458
Phone (847) 298-3079

2101 Waukegan Rd
Bannockburn, IL 60015-1836

250 S Northwest Hwy
Park Ridge, IL 60068-4237

Merit-based Incentive Payment System (MIPS)

Final score
81.07 of 100Reported as group
Quality
76.54
Promoting interoperability
83
Improvement activities
40
Cost
74.52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070012854ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Bone and Joint Institute LLC CurrentSince Aug 1, 2020 Accepting new patients
Illinois Bone and Joint Institute, LLC CurrentSince Aug 1, 2020 Accepting new patients
Accelerated Rehabilitation Centers, LTD Physical Therapist Past Accepting new patients
Accelerated Rehabilitation Centers, LTD Physical Therapist Past Accepting new patients

Locations

2101 Waukegan Rd
Ste 110
Bannockburn, IL 60015
Phone (847) 914-9096

5057 Paysphere Cir
Chicago, IL 60674

7447 W Talcott Ave
Ste 500
Chicago, IL 60631
Phone (312) 631-7898

900 Rand Rd
Ste 300
Des Plaines, IL 60016
Phone (847) 324-3090

250 S Northwest Hwy
Ste 204
Park Ridge, IL 60068
Phone (773) 631-4112

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581465600000",
    "number": "1164642872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7447 W TALCOTT AVE",
            "address_2": "STE 500",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313716",
            "telephone_number": "773-631-7898",
            "fax_number": "773-631-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7447 W TALCOTT AVE",
            "address_2": "STE 500",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313716",
            "telephone_number": "773-631-7898",
            "fax_number": "773-361-3005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODERICK",
        "first_name": "REGINA",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070012854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; 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.