Individual provider Active NPI

Jacqueline Gracia

  • Physical Therapist
  • Coppell, TX
National Provider Identifier
1184226797
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
106 N Denton Tap Rd Ste 220
Coppell, TX 75019-2139
Phone
(972) 979-6577
Fax
(972) 829-2564
NPI assigned
Nov 10, 2020
Last updated
Dec 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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 Primary

Addresses

Primary practice location

106 N Denton Tap Rd Ste 220
Coppell, TX 75019-2139

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other practice location 1

12747 Midway Rd Ste 150
Dallas, TX 75244-6304
Phone (972) 979-6577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Physical Therapy of Texas LLC Physical Therapist CurrentSince Oct 2, 2020 Accepting new patients
Texas Luna Care Physical Therapy LLC Physical Therapist CurrentSince Dec 5, 2024 Accepting new patients
Ideal Physical Therapy of Texas LLC CurrentSince Oct 2, 2020 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

17051 Dallas Pkwy
Ste 450
Addison, TX 75001
Phone (214) 272-8561

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

106 N Denton Tap Rd
Ste 220
Coppell, TX 75019
Phone (469) 528-6437

12747 Midway Rd
Ste 150
Dallas, TX 75244
Phone (469) 872-4562

2600 W 7th St
Ste 137
Fort Worth, TX 76107
Phone (682) 233-6462

180 State St
Ste 225
Southlake, TX 76092
Phone (682) 429-7066

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

3751 Main St
Ste 100
The Colony, TX 75056
Phone (469) 476-3523

Organizations & group practices 3

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": "1604966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1184226797",
    "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": "106 N DENTON TAP RD STE 220",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750192139",
            "telephone_number": "972-979-6577",
            "fax_number": "972-829-2564"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12747 Midway Rd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752446304",
            "country_code": "US",
            "telephone_number": "972-979-6577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRACIA",
        "first_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-10",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coppell, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.